Leonard David Williams IV DDS-PC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

LEONARD DAVID WILLIAMS IV DDS-PC

Doing business as

Southport Dental

Practice address

621A N Fodale Ave
Southport, NC 28461-3550

Phone

(910) 457-5026

NPI assigned

Jun 15, 2023

Last updated

Jun 15, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Leonard David Williams IV, DDSNPI 1538615414

Title

President

Phone

(316) 323-7933

Specialties & licenses 1

Addresses

Other names 1

• Southport Dental Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Leonard David Williams IV, D.D.S.

  • General Practice Dentistry
  • Southport, NC
  • NPI 1538615414
  NPD Authorized official

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

{
    "created_epoch": "1686787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686787200000",
    "number": "1922782218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621A N FODALE AVE",
            "city": "SOUTHPORT",
            "state": "NC",
            "postal_code": "284613550",
            "telephone_number": "910-457-5026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621A N FODALE AVE",
            "city": "SOUTHPORT",
            "state": "NC",
            "postal_code": "284613550",
            "telephone_number": "910-457-5026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEONARD DAVID WILLIAMS IV DDS-PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-15",
        "last_updated": "2023-06-15",
        "certification_date": "2023-06-15",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "LEONARD",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "316-323-7933",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "IV",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southport Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Matthew John Landfried, MD
• Michael Guy Langley, BS
• Larry L Hemby
• Learn Inspire Thrive-Lit Teen Substance Use Program
• Wendy Leo
• Eric Jon Lescault, DO
• Amanda Lewis
• Liberty Healthcare Group LLC (Liberty Commons Nursing & Rehabilitation Center of Southport, LLC)
• Liberty Healthcare Group, LLC (Southport Nursing Center)
• Debora Pyne Lipsen, P.T.

• Dental Clinic/Center in Southport, NC
• Providers in Southport, NC by specialty
• Dental Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2023; 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.