Individual provider Active NPI

Robert Williamson, DDS

  • Pediatric Dentistry
  • Sherman, TX
National Provider Identifier
1629164157
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
23222 Issued in TX
Practice address
2803 N Loy Lake Rd
Sherman, TX 75090-1726
Phone
(903) 892-2246
Fax
(903) 891-9339
NPI assigned
Oct 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 23222 TX Primary

Addresses

Primary practice location

2803 N Loy Lake Rd
Sherman, TX 75090-1726

Mailing address

2803 N Loy Lake Rd
Sherman, TX 75090-1726
Phone (903) 892-2246

Other practice location 1

275 W Princeton Dr Ste 100
Princeton, TX 75407-9712
Phone (972) 736-1000

Other identifiers 1

IdentifierTypeStateIssuer
1868887MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sherman Grayson Hospital LLC Current Accepting new patients

Interoperability endpoints

  • Direct secure messaging: robertwilliamson@wnjrmc.allscriptsdirect.net

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1629164157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2803 N LOY LAKE RD",
            "city": "SHERMAN",
            "state": "TX",
            "postal_code": "750901726",
            "telephone_number": "903-892-2246",
            "fax_number": "903-891-9339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2803 N LOY LAKE RD",
            "city": "SHERMAN",
            "state": "TX",
            "postal_code": "750901726",
            "telephone_number": "903-892-2246",
            "fax_number": "903-891-9339"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "275 W Princeton Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Princeton",
            "state": "TX",
            "postal_code": "754079712",
            "country_code": "US",
            "telephone_number": "972-736-1000",
            "fax_number": "972-736-1002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMSON",
        "first_name": "ROBERT",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "23222",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1868887",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherman, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.