Active NPI
William L Roberts, DDS
- Dentist
- Jackson, TN
National Provider Identifier
1962517615
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 5374
- Practice address
- 176A University Parkway West
Jackson, TN 38305 - Phone
- (731) 660-4488
- Fax
- (731) 660-4517
- NPI assigned
- Aug 21, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 5374 | TN | Primary |
Addresses
Primary practice location
176A University Parkway West
Jackson, TN 38305
Mailing address
176A University Parkway West
Jackson, TN 38305
Phone (731) 660-4488
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5374 | TN | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1962517615",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "176A UNIVERSITY PARKWAY WEST",
"city": "JACKSON",
"state": "TN",
"postal_code": "38305",
"telephone_number": "731-660-4488",
"fax_number": "731-660-4517"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "176A UNIVERSITY PARKWAY WEST",
"city": "JACKSON",
"state": "TN",
"postal_code": "38305",
"telephone_number": "731-660-4488",
"fax_number": "731-660-4517"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "WILLIAM",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TN",
"license": "5374",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jackson, TN
Sources for this page
- 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.