NPIMap

Organization Active NPI

Williams, Scheideman & Runyon, DDS PA

  • Oral and Maxillofacial Surgery (Dentist)
  • Fort Worth, TX
National Provider Identifier
1801913207
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
7817 Issued in TX
Legal business name
WILLIAMS, SCHEIDEMAN & RUNYON, DDS PA
Practice address
4300 Oak Park LN
Fort Worth, TX 76109-1512
Phone
(817) 731-2789
Fax
(817) 207-9980
NPI assigned
Mar 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Walter Gibbe Williams, DDS
Title
President
Phone
(817) 731-2789

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X 7817 TX Primary

Addresses

Primary practice location

4300 Oak Park LN
Fort Worth, TX 76109-1512

Mailing address

4300 Oak Park LN
Fort Worth, TX 76109-1512
Phone (817) 731-2789

National Provider Directory

National Provider Directory

Locations

4300 Oak Park Ln
Fort Worth, TX 76109
Phone (817) 731-2789

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1801913207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 OAK PARK LN",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761091512",
            "telephone_number": "817-731-2789",
            "fax_number": "817-207-9980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 OAK PARK LN",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761091512",
            "telephone_number": "817-731-2789",
            "fax_number": "817-207-9980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAMS, SCHEIDEMAN & RUNYON, DDS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "WALTER",
        "authorized_official_middle_name": "GIBBE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "817-731-2789",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "7817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

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