Mark N Williams, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

19-16261 Issued in IL

Practice address

Eastwood Drive
804-I Eastwood Center
Mahomet, IL 61853-0627

Phone

(217) 586-3535

Fax

(217) 586-3586

NPI assigned

Aug 24, 2006

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821105867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804-I EASTWOOD CENTER",
            "address_2": "PO BOX 627",
            "city": "MAHOMET",
            "state": "IL",
            "postal_code": "618530627",
            "telephone_number": "217-586-3535",
            "fax_number": "217-586-3586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "EASTWOOD DRIVE",
            "address_2": "804-I EASTWOOD CENTER",
            "city": "MAHOMET",
            "state": "IL",
            "postal_code": "618530627",
            "telephone_number": "217-586-3535",
            "fax_number": "217-586-3586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "MARK",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "19-16261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co.
• Walk Chiropractic and Acupuncture, Inc.
• Daniel L Walk, D.C.
• We Belong Behavior Services
• David K Webb, MD
• Megan Wilson, PHARMD
• Kathleen Wirth-Couch, LPC
• Clinton Matthew Witsman, DPT
• Valerie R Woodruff, DDS
• Amber M Wooldridge, MD

• General Practice Dentistry in Mahomet, IL
• Providers in Mahomet, IL by specialty
• General Practice Dentistry in Illinois

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.