Healthcare Provider Details

I. General information

NPI: 1073502217
Provider Name (Legal Business Name): ALEJANDRO LEONEL WILLIAMS DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2005
Last Update Date: 07/13/2026
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1624 UNIVERSITY BLVD
BRONX NY
10453-6948
US

IV. Provider business mailing address

1624 UNIVERSITY BLVD
BRONX NY
10453-6948
US

V. Phone/Fax

Practice location:
  • Phone: 718-294-3725
  • Fax: 718-466-0782
Mailing address:
  • Phone: 718-294-3725
  • Fax: 718-466-0782

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number045560-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code204E00000X
TaxonomyOral & Maxillofacial Surgery (D.M.D.)
License Number045560
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: