Active NPI
Lawrence Samuel Williams Jr., D.M.D.
- Public Health Dentistry
- Estill, SC
National Provider Identifier
1891989299
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Public Health Dentistry
- License
- 2901
- Practice address
- 100 Prison Road
Fed Corr Inst Estill
Estill, SC 29918-0699 - Phone
- (803) 625-4607
- Fax
- (803) 625-5636
- NPI assigned
- Aug 29, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health Dentistry | 1223D0001X | 2901 | SC | Primary |
Addresses
Primary practice location
100 Prison Road
Fed Corr Inst Estill
Estill, SC 29918-0699
Mailing address
PO Box 699
Fed Corr Inst Estill
Estill, SC 29918-0699
Phone (803) 625-4607
Other names 1
- Larry Williams
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2901 | SC | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Federal Correctional Ins Estill | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Prison Health Clinic/Center
- Estill, SC
- NPI 1174867857
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1188345600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1188345600000",
"number": "1891989299",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 699",
"address_2": "FED CORR INST ESTILL",
"city": "ESTILL",
"state": "SC",
"postal_code": "299180699",
"telephone_number": "803-625-4607",
"fax_number": "803-625-5636"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 PRISON ROAD",
"address_2": "FED CORR INST ESTILL",
"city": "ESTILL",
"state": "SC",
"postal_code": "299180699",
"telephone_number": "803-625-4607",
"fax_number": "803-625-5636"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "LAWRENCE",
"middle_name": "SAMUEL",
"name_suffix": "Jr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-08-29",
"last_updated": "2007-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "1223D0001X",
"taxonomy_group": "",
"desc": "Dentist, Dental Public Health",
"state": "SC",
"license": "2901",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "LARRY",
"last_name": "WILLIAMS",
"credential": "D.M.D.",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Estill, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 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.