Individual provider Active NPI

Nicholas Joseph Williams III, DDS

  • Endodontics
  • St Petersburg, FL
National Provider Identifier
1609039585
Registry record updated Jul 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
DN16231 Issued in FL
Practice address
2201 49TH St N
St Petersburg, FL 33710-3508
Phone
(727) 328-7929
NPI assigned
Jul 9, 2008
Last updated
Jul 9, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X DN16231 FL Primary

Addresses

Primary practice location

2201 49TH St N
St Petersburg, FL 33710-3508

Mailing address

2201 49TH St N
St Petersburg, FL 33710-3508
Phone (727) 328-7929

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150713001501 FL Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 6204147044

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1215561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215561600000",
    "number": "1609039585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 49TH ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337103508",
            "telephone_number": "727-328-7929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 49TH ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337103508",
            "telephone_number": "727-328-7929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "NICHOLAS",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-09",
        "last_updated": "2008-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "FL",
            "license": "DN16231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.