Active NPI
Julius A. Willis Jr., D.M.D.
- General Practice Dentistry
- Pascagoula, MS
National Provider Identifier
1659586485
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 1858-79
- Practice address
- 1226 Jackson Ave
Pascagoula, MS 39567-4348 - Phone
- (228) 769-9010
- NPI assigned
- May 14, 2007
- Last updated
- Jul 8, 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 1858-79 | MS | Primary |
Addresses
Primary practice location
1226 Jackson Ave
Pascagoula, MS 39567-4348
Mailing address
PO Box 1086
Pascagoula, MS 39568-1086
Phone (228) 769-9010
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1858-79 | MS | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| J.a. Willis, DMD and Russell Parker, DMD Family Dentistry | General Practice | Past | Accepting new patients |
| Gulf Islands Dentistry, PLLC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Dentist
- Pascagoula, MS
- NPI 1831576644
-
dba Willis & Parker Family Dentistry
- General Practice Dentistry
- Pascagoula, MS
- NPI 1760697437
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179100800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1659586485",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1086",
"city": "PASCAGOULA",
"state": "MS",
"postal_code": "395681086",
"telephone_number": "228-769-9010",
"fax_number": "228-762-0303"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1226 JACKSON AVE",
"city": "PASCAGOULA",
"state": "MS",
"postal_code": "395674348",
"telephone_number": "228-769-9010"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIS",
"first_name": "JULIUS",
"middle_name": "A.",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MS",
"license": "1858-79",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Pascagoula, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.