Mark J Williamson, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901013535 Issued in MI

Practice address

4279 W Vienna Rd
Clio, MI 48420-9440

Phone

(810) 659-1721

Fax

(810) 659-0897

NPI assigned

May 11, 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

Practice roles

Locations

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.

• Michigan Dental Sleep Center Inc

  • General Practice Dentistry
  • Clio, MI
  • NPI 1376908392
  NPD
• Michigan Dental Sleep Center Inc

  • Customized Equipment (DME)
  • Clio, MI
  • NPI 1679426134
  NPD
• BT Dental PC

  • Dental Clinic/Center
  • Flushing, MI
  • NPI 1487380143
  NPD (past)

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576713600000",
    "number": "1851341945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 210",
            "city": "FLUSHING",
            "state": "MI",
            "postal_code": "484330210",
            "telephone_number": "810-659-4561",
            "fax_number": "810-659-0897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4279 W VIENNA RD",
            "city": "CLIO",
            "state": "MI",
            "postal_code": "484209440",
            "telephone_number": "810-659-1721",
            "fax_number": "810-659-0897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMSON",
        "first_name": "MARK",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2019-12-19",
        "certification_date": "2019-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901013535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hannah Louise Wansitler, PA-C
• Katherine Warner, PA-C
• Anndrea Danae Weber
• Kelly Cay Welch
• Wildflower Therapy
• Chad Mark Witkow, D.D.S.
• David Lee Wood, RPH
• William Woods
• Andrea Lynn Worthing
• Worthwhile Wellness, PLLC

• General Practice Dentistry in Clio, MI
• Providers in Clio, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2019; 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.