Individual provider Active NPI

Hanief Williams Jr., DMD

  • General Practice Dentistry
  • Fruitland Park, FL
National Provider Identifier
1932620952
Registry record updated Nov 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN22631 Issued in FL
Practice address
3333 US Highway 441/27
Fruitland Park, FL 34731-4478
Phone
(203) 524-8854
NPI assigned
Jun 29, 2017
Last updated
Nov 17, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN22631 FL Primary

Addresses

Primary practice location

3333 US Highway 441/27
Fruitland Park, FL 34731-4478

Mailing address

3333 US Highway 441/27
Fruitland Park, FL 34731-4478
Phone (203) 524-8854

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181025001771 FL Order and Referring Only - DentistPractitioner - Dentist 8729331483

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN22631FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Williams Dentistry PLLC CurrentSince Nov 24, 2025 Accepting new patients
Thurston & Acosta Dental Associates,PL General Practice PastSince Jun 14, 2020 Accepting new patients
Thurston Comprehensive Dental Center General Practice PastSince Jun 14, 2020 Accepting new patients

Networks

  • Freedom Health HMO Network

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1498694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763337600000",
    "number": "1932620952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 US HIGHWAY 441/27",
            "city": "FRUITLAND PARK",
            "state": "FL",
            "postal_code": "347314478",
            "telephone_number": "203-524-8854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 US HIGHWAY 441/27",
            "city": "FRUITLAND PARK",
            "state": "FL",
            "postal_code": "347314478",
            "telephone_number": "203-524-8854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "HANIEF",
        "name_suffix": "Jr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-29",
        "last_updated": "2025-11-17",
        "certification_date": "2025-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN22631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fruitland Park, FL

Sources for this page

Verify at the official NPI Registry.