Haley Willis, D.D.S.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

13709 Issued in NC

Practice address

3616 Durham Chapel Hill Blvd
Durham, NC 27707-2661

Phone

(919) 493-2569

NPI assigned

May 2, 2017

Last updated

Jun 21, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 8

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": "1493683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718928000000",
    "number": "1881120582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "704 OPPOSITION WAY",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275876160",
            "telephone_number": "434-579-5515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3616 DURHAM CHAPEL HILL BLVD",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277072661",
            "telephone_number": "919-493-2569"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3200 Wendell Blvd",
            "address_purpose": "LOCATION",
            "city": "Wendell",
            "state": "NC",
            "postal_code": "275915908",
            "country_code": "US",
            "telephone_number": "919-355-3008",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4045 Riverside Dr",
            "address_purpose": "LOCATION",
            "city": "Danville",
            "state": "VA",
            "postal_code": "245415152",
            "country_code": "US",
            "telephone_number": "434-791-2142",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2200 Olympic St",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "OH",
            "postal_code": "455032858",
            "country_code": "US",
            "telephone_number": "937-390-0493",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4201 Saint Antoine St",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482012153",
            "country_code": "US",
            "telephone_number": "313-745-5146",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13015 Worldgate Dr",
            "address_purpose": "LOCATION",
            "city": "Herndon",
            "state": "VA",
            "postal_code": "201704374",
            "country_code": "US",
            "telephone_number": "703-543-4728",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "HALEY",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-02",
        "last_updated": "2024-06-21",
        "certification_date": "2024-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "OH",
            "license": "30.025784",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MD",
            "license": "17539",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "VA",
            "license": "0401417350",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NC",
            "license": "260191",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901022349",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "17539",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NC",
            "license": "13709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles Steadman Willis III, D.M.D.
• Charles Steadman Willis, DDS
• Christine Willis
• David Dawson Willis, MD
• Faith Noelle Willis, LCSW
• Karen N. Willis, CCSW
• Michael Gregory Willis, PHARM.D.
• Rheaya Willis, MD
• Lesharo Lashea Willoughby Haywood, CPNP-PC
• Ann S Willoughby

• Pediatric Dentistry in Durham, NC
• Providers in Durham, NC by specialty
• Pediatric Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2024; 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.