NPIMap

Organization Active NPI

Williams Oral and Maxillofacial Surgery

  • Oral and Maxillofacial Surgery Clinic/Center
  • Rapid City, SD
National Provider Identifier
1659543973
Registry record updated Mar 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X
License
M808 Issued in SD
Legal business name
WILLIAMS ORAL AND MAXILLOFACIAL SURGERY
Practice address
330 E Stumer Rd
Rapid City, SD 57701-6406
Phone
(605) 348-3400
Fax
(605) 348-1626
NPI assigned
Mar 26, 2008
Last updated
Mar 26, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2008

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

Authorized official

Name
Dr. Gregory P Williams, DDSNPI 1720126220
Title
Owner
Phone
(605) 348-3400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery Clinic/Center 261QS0112X M808 SD Primary

Addresses

Primary practice location

330 E Stumer Rd
Rapid City, SD 57701-6406

Mailing address

330 E Stumer Rd
Rapid City, SD 57701-6406
Phone (605) 348-3400

Other identifiers 3

IdentifierTypeStateIssuer
0003519OtherBLUE CROSS BLUE SHIELD
690846OtherUNITED CONCORDIA
8000390MedicaidSD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1206489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206489600000",
    "number": "1659543973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 E STUMER RD",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577016406",
            "telephone_number": "605-348-3400",
            "fax_number": "605-348-1626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 E STUMER RD",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577016406",
            "telephone_number": "605-348-3400",
            "fax_number": "605-348-1626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAMS ORAL AND MAXILLOFACIAL SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-26",
        "last_updated": "2008-03-26",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "605-348-3400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": "SD",
            "license": "M808",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0003519",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "690846",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8000390",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rapid City, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2008; 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.