Individual provider Active NPI

Marilee Reynolds Williford, DDS

  • General Practice Dentistry
  • Wilson, NC
National Provider Identifier
1699733717
Registry record updated Jun 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6555 Issued in NC
Practice address
2801B Wooten Blvd SW
Wilson, NC 27893-8625
Phone
(252) 237-8812
Fax
(252) 243-9036
NPI assigned
May 1, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 6555 NC Primary

Addresses

Primary practice location

2801B Wooten Blvd SW
Wilson, NC 27893-8625

Mailing address

2801B Wooten Blvd SW
Wilson, NC 27893-8625
Phone (252) 237-8812

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20150803000578 NC Order and Referring Only - DentistPractitioner - Dentist 4587978622

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6555NCMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Dixon and Holmes DDS, PA General Practice Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688083200000",
    "number": "1699733717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801B WOOTEN BLVD SW",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278938625",
            "telephone_number": "252-237-8812",
            "fax_number": "252-243-9036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801B WOOTEN BLVD SW",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278938625",
            "telephone_number": "252-237-8812",
            "fax_number": "252-243-9036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIFORD",
        "first_name": "MARILEE",
        "middle_name": "REYNOLDS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-01",
        "last_updated": "2023-06-30",
        "certification_date": "2023-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "6555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilson, NC

Sources for this page

Verify at the official NPI Registry.