Individual provider Active NPI

Rachel Isabelle Williams, DDS

  • Dentist
  • Manassas, VA
National Provider Identifier
1720196959
Registry record updated Jan 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0401414200 Issued in VA
Practice address
10529 Crestwood Dr
Manassas, VA 20109-4418
Phone
(425) 283-6912
NPI assigned
Aug 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 1, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 5892 C1 AL
Dentist 122300000X DR20000163 WA
Dentist 122300000X 1649 OK
Dentist 122300000X 0401414200 VA Primary

Addresses

Primary practice location

10529 Crestwood Dr
Manassas, VA 20109-4418

Mailing address

7754 Tara Heights PL
Springfield, VA 22153-2239
Phone (425) 283-6912

Other practice location 1

1934 Chancellor Ridge Rd
Prattville, AL 36066-5526
Phone (425) 283-6912

Other names 1

  • Rachel Isabelle Evans Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20160610001825 WA Order and Referring Only - DentistPractitioner - Dentist 1951691476

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5892 C1ALMDDentist
0401414200VAMDDentist
DR20000163WAMDDentist
1649OKMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609459200000",
    "number": "1720196959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7754 TARA HEIGHTS PL",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "221532239",
            "telephone_number": "425-283-6912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10529 CRESTWOOD DR",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201094418",
            "telephone_number": "425-283-6912"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1934 Chancellor Ridge Rd",
            "address_purpose": "LOCATION",
            "city": "Prattville",
            "state": "AL",
            "postal_code": "360665526",
            "country_code": "US",
            "telephone_number": "425-283-6912",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "RACHEL",
        "middle_name": "ISABELLE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-28",
        "last_updated": "2021-01-01",
        "certification_date": "2021-01-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AL",
            "license": "5892 C1",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DR20000163",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OK",
            "license": "1649",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401414200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RACHEL",
            "last_name": "EVANS",
            "middle_name": "ISABELLE",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Manassas, VA

Sources for this page

Verify at the official NPI Registry.