Allena Willis, DMD

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

DEN1000484 Issued in DC

Practice address

2021 K St NW
#301
Washington, DC 20006-1003

Phone

(202) 379-5103

Fax

(972) 992-9865

NPI assigned

Jun 29, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Mrs. Allena Willis Kennerly Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1183075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902003312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2021 K STREET NW",
            "address_2": "#301",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "20006",
            "telephone_number": "202-379-5103",
            "fax_number": "972-992-9865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 K ST NW",
            "address_2": "#301",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200061003",
            "telephone_number": "202-379-5103",
            "fax_number": "972-992-9865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "ALLENA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "DC",
            "license": "DEN1000484",
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MD",
            "license": "13861",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALLENA",
            "last_name": "KENNERLY",
            "middle_name": "WILLIS",
            "prefix": "MRS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Rachael Willie
• Virginia Lela Williford
• Laura Marie Willing, M.D.
• John Willingham
• Landon Willingham, DPT
• Alyssa Alexondra Willis
• Asha Dalilah Willis, M.D.
• Brooke Lynn Willis, OTD, OTR/L
• Chanee A Willis
• Donald James Willis, LICSW, LCSW-C

• Orthodontics and Dentofacial Orthopedics Dentistry in Washington, DC
• Providers in Washington, DC by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in District of Columbia

• 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.