NPIMap

Organization Active NPI

Robert L Williamson III DDS2

  • Dentist
  • Raleigh, NC
National Provider Identifier
1720159262
Registry record updated Oct 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
7038 Issued in NC
Legal business name
ROBERT L WILLIAMSON III DDS2
Practice address
119 N Boylan Ave
B
Raleigh, NC 27603-1422
Phone
(919) 755-3748
Fax
(919) 828-4937
NPI assigned
Nov 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2015

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

Authorized official

Name
Ms. Nancy Campbell
Title
Operations Director
Phone
(919) 755-3748

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 7038 NC Primary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 9144 NC
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 9316 NC

Addresses

Primary practice location

119 N Boylan Ave
B
Raleigh, NC 27603-1422

Mailing address

119-B N Boylan Ave
Raleigh, NC 27603-1422
Phone (919) 755-3748

Other identifiers 3

IdentifierTypeStateIssuer
5902123MedicaidNC
5919352MedicaidNC
89902EJMedicaidNC

Other names 1

  • Raleigh Comprehensive & Cosmetic Dentistry Cameron Village Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Raleigh Comprehensive Cosmetic Dentistry Cameron Village2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

119 N Boylan Ave
#B
Raleigh, NC 27603
Phone (919) 755-3748

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445472000000",
    "number": "1720159262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119-B N BOYLAN AVE",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276031422",
            "telephone_number": "919-755-3748",
            "fax_number": "919-828-4937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 N BOYLAN AVE",
            "address_2": "B",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276031422",
            "telephone_number": "919-755-3748",
            "fax_number": "919-828-4937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT L WILLIAMSON III DDS2",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2015-10-22",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "NANCY",
        "authorized_official_title_or_position": "OPERATIONS DIRECTOR",
        "authorized_official_telephone_number": "919-755-3748",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NC",
            "license": "7038",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NC",
            "license": "9144",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NC",
            "license": "9316",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5902123",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5919352",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89902EJ",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Raleigh Comprehensive & Cosmetic Dentistry Cameron Village",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2015; 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.