Individual provider Active NPI

Thomas Cheney Williams, D.M.D.

  • General Practice Dentistry
  • Fayetteville, GA
National Provider Identifier
1851311534
Registry record updated Aug 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
8464 Issued in GA
Practice address
265 N Jeff Davis Dr
Suite #1
Fayetteville, GA 30214-1625
Phone
(678) 817-5900
Fax
(678) 817-1775
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2010

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 8464 GA Primary
Dentist 122300000X 8464 GA

Addresses

Primary practice location

265 N Jeff Davis Dr
Suite #1
Fayetteville, GA 30214-1625

Mailing address

265 N Jeff Davis Dr
Suite #1
Fayetteville, GA 30214-1625
Phone (678) 817-5900

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20151229002676 GA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 0648572131

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8464GAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Williams Orthodontics, LLC Dentist Past Accepting new patients
Jeff Davis Dental, LLC General Practice Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282953600000",
    "number": "1851311534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "265 N JEFF DAVIS DR",
            "address_2": "SUITE #1",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302141625",
            "telephone_number": "678-817-5900",
            "fax_number": "678-817-1775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "265 N JEFF DAVIS DR",
            "address_2": "SUITE #1",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302141625",
            "telephone_number": "678-817-5900",
            "fax_number": "678-817-1775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "THOMAS",
        "middle_name": "CHENEY",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2010-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "8464",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "8464",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, GA

Sources for this page

Verify at the official NPI Registry.