Provider Demographics
NPI:1023025608
Name:WILLIAMS, JOHN STUART (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:STUART
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1811 GREENVILLE AVE APT 1105
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75206-7479
Mailing Address - Country:US
Mailing Address - Phone:210-214-0809
Mailing Address - Fax:
Practice Address - Street 1:272 S COLLINS RD STE 100
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:TX
Practice Address - Zip Code:75182-4643
Practice Address - Country:US
Practice Address - Phone:972-216-1871
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX205591223G0001X
NC75061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice