Jonathon Logan Williams, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401416956 Issued in VA

Practice address

175 Market Ridge LN
Daleville, VA 24083-3260

Phone

(540) 992-1004

NPI assigned

Jul 1, 2020

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• CLQ&P Dentistry PLLC

  • Dentist
  • Roanoke, VA
  • NPI 1740995471
  NPD
• Coots Ward Cross Dentistry

  • General Practice Dentistry
  • Roanoke, VA
  • NPI 1740359405
  NPD (past)

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

{
    "created_epoch": "1593561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593561600000",
    "number": "1790302180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 ELECTRIC RD",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240181621",
            "telephone_number": "540-989-1170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 MARKET RIDGE LN",
            "city": "DALEVILLE",
            "state": "VA",
            "postal_code": "240833260",
            "telephone_number": "540-992-1004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JONATHON",
        "middle_name": "LOGAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-01",
        "last_updated": "2020-07-01",
        "certification_date": "2020-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401416956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Holland Walker, D.O
• Audrey A Ward, PT
• Harold W Ward, PT
• Beth W Weber, R.PH.
• Emily Welch
• Martha Lynn Wilson, MOT, OTR/L
• Jacob Tyler Wright, DPT
• Tracey Ann Zelenske, COTA/L
• Isabella Zornes

• General Practice Dentistry in Daleville, VA
• Providers in Daleville, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2020; 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.