Christopher Derek Williams, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12319869-9923 Issued in UT

Practice address

1090 Arnold Dr
Little Rock Afb, AR 72099-4933

Phone

(507) 987-7304

NPI assigned

Mar 1, 2021

Sex

Male

Sole proprietor

No

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 AR

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

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

{
    "created_epoch": "1614556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663804800000",
    "number": "1760077846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1090 ARNOLD DR",
            "city": "LITTLE ROCK AFB",
            "state": "AR",
            "postal_code": "720994933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1090 ARNOLD DR",
            "city": "LITTLE ROCK AFB",
            "state": "AR",
            "postal_code": "720994933",
            "telephone_number": "507-987-7304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "CHRISTOPHER",
        "middle_name": "DEREK",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-01",
        "last_updated": "2022-09-22",
        "certification_date": "2022-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "12319869-9923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Seth Thomas Tolliver, APN, FNP-BC
• Robin Malinda Trousdale
• Michelle Ufford, LSCSW
• James Peter Vakos, PT
• Hailey Marie Washam, LCSW
• Emily Jo Wilson, DDS
• Jennifer L Wilson, RN
• Nancy Pratt Wilson, NURSE PRACTITIONER
• Millicent M Wren, RDH
• Clarissa Nicole Yarborough, FNP

• General Practice Dentistry in Little Rock Afb, AR
• Providers in Little Rock Afb, AR by specialty
• General Practice Dentistry in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2022; 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.