Healthcare Provider Details

I. General information

NPI: 1376469031
Provider Name (Legal Business Name): TYLER WILLIAMS DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8913 WOODYARD RD # B
CLINTON MD
20735-4257
US

IV. Provider business mailing address

731 SEATON AVE UNIT 531
ALEXANDRIA VA
22305-3072
US

V. Phone/Fax

Practice location:
  • Phone: 301-246-8404
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number18754
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: