Active NPI
Kenneth Scott Williams, D.D.S.
- Dentist
- Irving, TX
National Provider Identifier
1619097888
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 15220
- Practice address
- 7301 State Highway 161
Suite198
Irving, TX 75039-2816 - Phone
- (972) 869-3789
- NPI assigned
- Mar 30, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 15220 | TX | Primary |
Addresses
Primary practice location
7301 State Highway 161
Suite198
Irving, TX 75039-2816
Mailing address
PO Box 1078
Allen, TX 75013-0017
Phone (972) 743-6561
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160425001254 | TX | Order and Referring Only - Oral Surgery | 5294034336 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15220 | TX | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175212800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658448000000",
"number": "1619097888",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1078",
"city": "ALLEN",
"state": "TX",
"postal_code": "750130017",
"telephone_number": "972-743-6561"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7301 STATE HIGHWAY 161",
"address_2": "SUITE198",
"city": "IRVING",
"state": "TX",
"postal_code": "750392816",
"telephone_number": "972-869-3789"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "KENNETH",
"middle_name": "SCOTT",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-30",
"last_updated": "2022-07-22",
"certification_date": "2022-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "15220",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Irving, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.