Jerald V Williams, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN19666 Issued in FL

Practice address

322 S 6TH Ave
Wauchula, FL 33873-3207

Phone

(863) 333-9192

NPI assigned

Mar 19, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Networks

• Freedom Health HMO Network

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1659495273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 SOUTH 6TH AVE",
            "city": "WAUCHULA",
            "state": "FL",
            "postal_code": "33873",
            "telephone_number": "863-333-9192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 S 6TH AVE",
            "city": "WAUCHULA",
            "state": "FL",
            "postal_code": "338733207",
            "telephone_number": "863-333-9192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JERALD",
        "middle_name": "V",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-19",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN012437",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN19666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wauchula Hma Physician Management, LLC
• Wauchula Integrated Networked Neurologic Rehabilitation, Inc.
• Wauhcula Dental Corp.
• West Central Florida Transportation, LLC
• Hunter Marie Williams, PT
• Robert Allen Williams, D.O.
• Shaquena Ylieret
• Deborah Zolkos, APRN

• General Practice Dentistry in Wauchula, FL
• Providers in Wauchula, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.