Individual provider Active NPI

Arthur E Williams II, D.D.S.

  • Dentist
  • Oak Park, MI
National Provider Identifier
1689763005
Registry record updated Jan 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12594 Issued in MI
Practice address
25101 Coolidge Hwy
Oak Park, MI 48237-1404
Phone
(313) 838-0480
Fax
(313) 838-4974
NPI assigned
Oct 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2011

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 12594 MI Primary
Pediatric Dentistry 1223P0221X 24152 TX
Pediatric Dentistry 1223P0221X 12594 MI

Addresses

Primary practice location

25101 Coolidge Hwy
Oak Park, MI 48237-1404

Mailing address

PO Box 35350
Detroit, MI 48235-0350
Phone (313) 838-0480

Other identifiers 1

IdentifierTypeStateIssuer
4061443MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160218002064 TX Order and Referring Only - DentistPractitioner - Dentist 1355646944

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12594MIMDPediatric Dentist

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295308800000",
    "number": "1689763005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35350",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482350350",
            "telephone_number": "313-838-0480",
            "fax_number": "313-924-8262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25101 COOLIDGE HWY",
            "city": "OAK PARK",
            "state": "MI",
            "postal_code": "482371404",
            "telephone_number": "313-838-0480",
            "fax_number": "313-838-4974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS II",
        "first_name": "ARTHUR",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2011-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "12594",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "24152",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MI",
            "license": "12594",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4061443",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Park, MI

Sources for this page

Verify at the official NPI Registry.