William S Odom Jr., D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

10277 Issued in GA

Practice address

424 9TH St
Suite #1
Columbus, GA 31901-2895

Phone

(706) 327-9936

NPI assigned

Jul 16, 2005

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

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in GA

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

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

{
    "created_epoch": "1121472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418774400000",
    "number": "1790784338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "424 9TH ST",
            "address_2": "SUITE #1",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319012895",
            "telephone_number": "706-327-9936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "424 9TH ST",
            "address_2": "SUITE #1",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319012895",
            "telephone_number": "706-327-9936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODOM",
        "first_name": "WILLIAM",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-16",
        "last_updated": "2014-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "10277",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE-DORAL",
            "identifier": "9181476",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "820713",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00318029A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PEACHSTATE-AVESIS",
            "identifier": "100661",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Occupational Medicine of Columbus
• Joanne C Oconnor, PT
• Rachel Akoth Odillia
• Christopher William Odom, D.C.
• Jazze Odom
• Nicole Ann Odum, FNP
• Odyssey Management Group LLC
• Tunisha Oestricher
• Myeshia Offord
• Takia Marcellus Oglesby, M.D.

• General Practice Dentistry in Columbus, GA
• Providers in Columbus, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2014; 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.