Individual provider Active NPI

Brian D Williams, DDS

  • General Practice Dentistry
  • Fort Worth, TX
National Provider Identifier
1710271457
Registry record updated May 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
26572 Issued in TX
Practice address
639 Sherry LN
Fort Worth, TX 76114-4018
Phone
(817) 737-7711
NPI assigned
May 29, 2011
Last updated
May 29, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2011

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 26572 TX Primary

Addresses

Primary practice location

639 Sherry LN
Fort Worth, TX 76114-4018

Mailing address

4929 Seneca Dr
Dallas, TX 75209-2217
Phone (210) 296-4989

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

LicenseStateTypeSpecialty
26572TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Cinco Meadows Dental PLLC Current Accepting new patients
Archstone Dental PLLC General Practice Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1306627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306627200000",
    "number": "1710271457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4929 SENECA DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752092217",
            "telephone_number": "210-296-4989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "639 SHERRY LN",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761144018",
            "telephone_number": "817-737-7711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "BRIAN",
        "middle_name": "D",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-29",
        "last_updated": "2011-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "26572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.