Michael S Willis, D.M.D.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DS9672 Issued in TN

Practice address

445 Henslee Drive
Ste B
Dickson, TN 37055

Phone

(615) 441-1441

Fax

(615) 441-1460

NPI assigned

Aug 9, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Orlando Oral & Facial Surgery PLLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Winter Park, FL
  • NPI 1205920204
  NPD (past)

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477526400000",
    "number": "1912917238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 HENSLEE DRIVE",
            "address_2": "STE B",
            "city": "DICKSON",
            "state": "TN",
            "postal_code": "37055",
            "telephone_number": "615-441-1441",
            "fax_number": "615-441-1460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 HENSLEE DRIVE",
            "address_2": "STE B",
            "city": "DICKSON",
            "state": "TN",
            "postal_code": "37055",
            "telephone_number": "615-441-1441",
            "fax_number": "615-441-1460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "MICHAEL",
        "middle_name": "S",
        "name_prefix": "Mr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2016-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "DN011177",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TN",
            "license": "9672",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TN",
            "license": "DS9672",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "DN11177",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katie Wiegand
• Bradley A Wiles, LMFT
• Camerone Williams
• Debra Renay Williams, LPN
• Jaret Williamson
• Scott Alan Wilson, MS
• Walter Brad Wilson, PT
• William Storm Wilson, DPT
• Cathleen Wixon, M.A.
• Leslie Shepard Wolfe, PHARM.D.

• Oral and Maxillofacial Surgery (Dentist) in Dickson, TN
• Providers in Dickson, TN by specialty
• Oral and Maxillofacial Surgery (Dentist) in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2016; 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.