Active NPI
Terry Charles Williams, D D S
- General Practice Dentistry
- Independence, MO
National Provider Identifier
1659768596
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 10173
- Practice address
- 17008 E 45TH St S
Independence, MO 64055-7630 - Phone
- (816) 590-2987
- NPI assigned
- Apr 17, 2015
- 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 | 10173 | MO | Primary |
Addresses
Primary practice location
17008 E 45TH St S
Independence, MO 64055-7630
Mailing address
17008 E 45TH St S
Independence, MO 64055-7630
Phone (816) 590-2987
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992786412 | Other | MO | UMKC SCHOOL OF DENTISTRY |
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 |
|---|---|---|---|
| 10173 | MO | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1429228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1429228800000",
"number": "1659768596",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17008 E 45TH ST S",
"city": "INDEPENDENCE",
"state": "MO",
"postal_code": "640557630",
"telephone_number": "816-590-2987"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17008 E 45TH ST S",
"city": "INDEPENDENCE",
"state": "MO",
"postal_code": "640557630",
"telephone_number": "816-590-2987"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "TERRY",
"middle_name": "CHARLES",
"credential": "D D S",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-04-17",
"last_updated": "2015-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MO",
"license": "10173",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UMKC SCHOOL OF DENTISTRY",
"identifier": "1992786412",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Independence, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.