Healthcare Provider Details

I. General information

NPI: 1851479000
Provider Name (Legal Business Name): CLAUDIA NICKOLE WILLIAMS-CONERLY DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DR. CLAUDIA NICKOLE WILLIAMS

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 11/01/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10313 GEORGIA AVE STE 210
SILVER SPRING MD
20902-5006
US

IV. Provider business mailing address

10313 GEORGIA AVE STE 210
SILVER SPRING MD
20902-5006
US

V. Phone/Fax

Practice location:
  • Phone: 301-565-3536
  • Fax: 301-576-3536
Mailing address:
  • Phone: 301-565-3536
  • Fax: 301-576-3536

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License Number2901017593
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number14126
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: