Richard A. Williams, DDS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

4569 Issued in TN

Practice address

399 Southcrest CT
Suite B
Southaven, MS 38671-4790

Phone

(662) 349-2196

Fax

(662) 349-8349

NPI assigned

Mar 29, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599091200000",
    "number": "1972623775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 UNION AVE S-301",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381634790",
            "telephone_number": "901-448-6210",
            "fax_number": "901-448-8358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "399 SOUTHCREST CT",
            "address_2": "SUITE B",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386714790",
            "telephone_number": "662-349-2196",
            "fax_number": "662-349-8349"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "875 Union Ave S-301",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381634790",
            "country_code": "US",
            "telephone_number": "901-448-6213",
            "fax_number": "901-448-8358",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "RICHARD",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-29",
        "last_updated": "2020-09-03",
        "certification_date": "2020-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MS",
            "license": "MS 2039-83",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "TN",
            "license": "4569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Williams, PHARMD
• Jamila Williams, SLP
• Kiara Keuntay Williams
• Kimberly Rena Williams
• Michael David Williams, NP-C
• Sarah A Williams
• Sarah Womack Williams, AUD
• Tajuana Lashe' Williams, M.ED, NCC, LPC
• Tracy Leigh Williamson, RDN, LD
• Robin Willis, PHARMD

• Orthodontics and Dentofacial Orthopedics Dentistry in Southaven, MS
• Providers in Southaven, MS by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2020; 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.