Gregory P Williams, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

M808 Issued in SD

Practice address

330 E Stumer Rd
Rapid City, SD 57701-6406

Phone

(605) 348-3400

Fax

(605) 348-1626

NPI assigned

Feb 5, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Apr 24, 2024 through Apr 24, 2028

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467072000000",
    "number": "1720126220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 E STUMER RD",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577016406",
            "telephone_number": "605-348-3400",
            "fax_number": "605-348-1626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 E STUMER RD",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577016406",
            "telephone_number": "605-348-3400",
            "fax_number": "605-348-1626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "GREGORY",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-05",
        "last_updated": "2016-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "SD",
            "license": "M808",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8000390",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Williams Oral and Maxillofacial Surgery, Prof. L.L.C.
• Williams Psychological, LLC
• Braden Williams
• Bridget Theresa Williams, MS
• Elizabeth Anne Williams, MSPT
• Jennifer Williams
• Karli M Williams, D.D.S.
• Shannon Alexandria Williams, MD
• Heather Ann Williamson, P.T.
• Ingrid Williamson

• Oral and Maxillofacial Surgery (Dentist) in Rapid City, SD
• Providers in Rapid City, SD by specialty
• Oral and Maxillofacial Surgery (Dentist) in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.