Jack Lawrence Williams, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7400 Issued in IN

Practice address

5150 E Stop 11 Rd
Suite 11
Indianapolis, IN 46237-8628

Phone

(317) 889-6000

Fax

(317) 889-1618

NPI assigned

Jul 31, 2006

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

Medicare fee-for-service enrollment

Enrolled in IN

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Idc Dental Group, Inc.

  • General Practice Dentistry
  • Indianapolis, IN
  • NPI 1093164535
  NPD (past)
• Jillian C. Brady, DDS, LLC

  • Dental Clinic/Center
  • Indianapolis, IN
  • NPI 1033746136
  NPD (past)

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463616000000",
    "number": "1730195892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5150 E STOP 11 RD",
            "address_2": "SUITE 11",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462378628",
            "telephone_number": "317-889-6000",
            "fax_number": "317-889-1618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5150 E STOP 11 RD",
            "address_2": "SUITE 11",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462378628",
            "telephone_number": "317-889-6000",
            "fax_number": "317-889-1618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JACK",
        "middle_name": "LAWRENCE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2016-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "7400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hannah Williams
• Heather Celia Williams, MD
• Heather Dawn Williams, DPT, C/NDT
• Heather Jean Williams, FNP-C
• Honey Kate Gandionco Williams, CNP
• Jacob Williams
• Jacob Zane Williams, MD
• Jacqueline Williams, PHD
• Jacqueline Williams
• James Williams, PA

• General Practice Dentistry in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.