Active NPI
John Barry Williamson, D.D.S.
- Dentist
- San Leandro, CA
National Provider Identifier
1699924712
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 33404
- Practice address
- 1450 Bancroft Ave.
San Leandro, CA 94577 - Phone
- (510) 483-2412
- Fax
- (510) 483-2517
- NPI assigned
- Sep 12, 2008
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 33404 | CA | Primary |
Addresses
Primary practice location
1450 Bancroft Ave.
San Leandro, CA 94577
Mailing address
1450 Bancroft Ave.
San Leandro, CA 94577
Phone (510) 483-2412
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1221177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1221177600000",
"number": "1699924712",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1450 BANCROFT AVE.",
"city": "SAN LEANDRO",
"state": "CA",
"postal_code": "94577",
"telephone_number": "510-483-2412",
"fax_number": "510-483-2517"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1450 BANCROFT AVE.",
"city": "SAN LEANDRO",
"state": "CA",
"postal_code": "94577",
"telephone_number": "510-483-2412",
"fax_number": "510-483-2517"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMSON",
"first_name": "JOHN",
"middle_name": "BARRY",
"name_prefix": "Mr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-09-12",
"last_updated": "2008-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "33404",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Leandro, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.