Michael C Williams, D.M.D.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

DN012544 Issued in GA

Practice address

112 Harmony Xing Ste 1
Eatonton, GA 31024-9536

Phone

(706) 984-4484

Fax

(706) 484-9846

NPI assigned

Dec 20, 2006

Last updated

Aug 28, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jul 1, 2017 through Jul 1, 2027

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lake Oconee Endodontics, LLC

  • Endodontics
  • Greensboro, GA
  • NPI 1720342694
  NPD Authorized official

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377648000000",
    "number": "1629132170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 HARMONY XING STE 1",
            "city": "EATONTON",
            "state": "GA",
            "postal_code": "310249536",
            "telephone_number": "706-984-4484",
            "fax_number": "706-484-9846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 HARMONY XING STE 1",
            "city": "EATONTON",
            "state": "GA",
            "postal_code": "310249536",
            "telephone_number": "706-984-4484",
            "fax_number": "706-484-9846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "MICHAEL",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-20",
        "last_updated": "2013-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "GA",
            "license": "DN012544",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "6789540001",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberly Goodwin Warnock, NP-C
• Jana Lennon Weems, P.T.
• Jacqueline Odessa Wells, MASSAGE THERAPIST
• John Anthony Wheeler, PHD, NCC, ACS, MDIV,
• Lee McLean Whitesides, DMD
• Diana E. Wilson, AUDIOLOGIST
• Worker's Wellness Clinic
• Savannah Alexis Writch, NP
• Young-Jones Dental Center
• Dorothy A Young-Jones, D.D.S.

• Endodontics in Eatonton, GA
• Providers in Eatonton, GA by specialty
• Endodontics in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2013; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.