Individual provider Active NPI

Justus Williams, DDS

  • General Practice Dentistry
  • Brooklyn, NY
National Provider Identifier
1790462653
Registry record updated Feb 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4823 Issued in AR
Practice address
1 Brookdale PLZ
Brooklyn, NY 11212-3139
Phone
(479) 970-6014
NPI assigned
Jul 3, 2023
Last updated
Feb 14, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 4823 AR Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1 Brookdale PLZ
Brooklyn, NY 11212-3139

Mailing address

545 40TH St
Brooklyn, NY 11232-3003
Phone (479) 970-6014

Other practice location 1

406 N Church St # 4149
Atkins, AR 72823-4149
Phone (479) 641-1081

Other practice location 2

1204 S Rogers St
Clarksville, AR 72830-9159
Phone (479) 977-6453

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4823ARMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Leeds and Wisener PLLC General Practice PastSince Jul 13, 2025 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1688342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739491200000",
    "number": "1790462653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "545 40TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112323003",
            "telephone_number": "479-970-6014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BROOKDALE PLZ",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112123139",
            "telephone_number": "479-970-6014"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "406 N Church St # 4149",
            "address_purpose": "LOCATION",
            "city": "Atkins",
            "state": "AR",
            "postal_code": "728234149",
            "country_code": "US",
            "telephone_number": "479-641-1081",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1204 S Rogers St",
            "address_purpose": "LOCATION",
            "city": "Clarksville",
            "state": "AR",
            "postal_code": "728309159",
            "country_code": "US",
            "telephone_number": "479-977-6453",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JUSTUS",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-03",
        "last_updated": "2025-02-14",
        "certification_date": "2025-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "4823",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2025; 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.