NPIMap

Organization Active NPI

Willis 1 Dentistry PLLC

  • Dental Clinic/Center
  • El Campo, TX
National Provider Identifier
1922553759
Registry record updated Jun 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
27076 Issued in TX
Legal business name
WILLIS 1 DENTISTRY PLLC
Practice address
1108 N Mechanic St
El Campo, TX 77437-3030
Phone
(979) 541-5400
NPI assigned
Aug 22, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2025

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

Authorized official

Name
Shaun Willis, DMDNPI 1942597976
Title
Owner
Phone
(979) 541-5400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 27076 TX Primary

Addresses

Primary practice location

1108 N Mechanic St
El Campo, TX 77437-3030

Mailing address

1108 N Mechanic St
El Campo, TX 77437-3030
Phone (979) 541-5400

Other identifiers 1

IdentifierTypeStateIssuer
27076OtherTXSTATE LICENSE

National Provider Directory

National Provider Directory

Locations

1108 N Mechanic St
El Campo, TX 77437
Phone (979) 541-5400

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1471824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750032000000",
    "number": "1922553759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1108 N MECHANIC ST",
            "city": "EL CAMPO",
            "state": "TX",
            "postal_code": "774373030",
            "telephone_number": "979-541-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1108 N MECHANIC ST",
            "city": "EL CAMPO",
            "state": "TX",
            "postal_code": "774373030",
            "telephone_number": "979-541-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIS 1 DENTISTRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-22",
        "last_updated": "2025-06-16",
        "certification_date": "2025-06-16",
        "status": "A",
        "authorized_official_last_name": "WILLIS",
        "authorized_official_first_name": "SHAUN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "979-541-5400",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "TX",
            "license": "27076",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "27076",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Campo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2025; 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.