Bradley W Willis, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4554 Issued in AL

Practice address

8161 Seaton Place
Suite a
Montgomery, AL 36116

Phone

(334) 260-2929

Fax

(334) 396-7874

NPI assigned

Aug 28, 2006

Last updated

Nov 3, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

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

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Bradley W. Willis,

  dba Willis Dental Care

  • Dental Clinic/Center
  • Montgomery, AL
  • NPI 1285016154
  NPD (past) Authorized official

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

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446508800000",
    "number": "1689782781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8161 SEATON PLACE",
            "address_2": "SUITE A",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "36116",
            "telephone_number": "334-260-2929",
            "fax_number": "334-396-7874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8161 SEATON PLACE",
            "address_2": "SUITE A",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "36116",
            "telephone_number": "334-260-2929",
            "fax_number": "334-396-7874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "BRADLEY",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-28",
        "last_updated": "2015-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "4554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Harris Williams III, D.M.D.
• Valeria Charlene Williams
• Ashley Williamson
• Claudine Williamson
• Donald E. Williamson, M.D.
• Britney Willis
• Curtis Willis, C.R.N.A.
• Jessica Willis, RN
• Dianne Kay Wills, CRNP
• Wilson Family Dentistry LLC

• General Practice Dentistry in Montgomery, AL
• Providers in Montgomery, AL by specialty
• General Practice Dentistry in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.