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General NPI Number Information
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NPI Number | 1528470309
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Entity Type | Individual
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Provider Name | JOHNNY WILLIAMS D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/28/2014
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Last Update Date | 02/02/2021
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Provider Practice Location Address
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Address Line | 264 NEW SHACKLE ISLAND RD STE 105A
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City | HENDERSONVILLE
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State | TN
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Zip | 37075-2482
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Country | US
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Telephone | 615-447-5011
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Fax |
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Provider Business Mailing Address
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Address Line | 264 NEW SHACKLE ISLAND RD STE 105A
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City | HENDERSONVILLE
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State | TN
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Zip | 37075-2482
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Country | US
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Telephone | 615-447-5011
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN 20594
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 10712
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License Number State | TN
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