Thomas T. Willis, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3373 Issued in AL

Practice address

2691 Sandlin Rd SW Ste C
Decatur, AL 35601-7362

Phone

(256) 350-4616

Fax

(256) 350-4819

NPI assigned

Mar 12, 2007

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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Welden Ondocsin Dentistry LLC

  • General Practice Dentistry
  • Decatur, AL
  • NPI 1760915714
  NPD (past)

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811029119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2691 SANDLIN RD SW STE C",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356017362",
            "telephone_number": "256-350-4616",
            "fax_number": "256-350-4819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2691 SANDLIN RD SW STE C",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356017362",
            "telephone_number": "256-350-4616",
            "fax_number": "256-350-4819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "THOMAS",
        "middle_name": "T.",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "3373",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "537865",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF AL",
            "identifier": "97608",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kerri Anne Williams, DPT
• Sandra Sue Williams, RN
• Shawnna B Williams, CRNP
• Tanya Williams, REGISTERED NURSE
• Willis Taylor Williams, M.D.
• Anthony L Wilson
• Katherine Wilson, CRNP
• Samuel Wilson, MD
• Matthew Gary Witzel, M.D.
• Ann Elizabeth Wood, MSN, CRNP

• General Practice Dentistry in Decatur, AL
• Providers in Decatur, AL by specialty
• General Practice Dentistry in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.