Provider Demographics
NPI:1043506199
Name:WILLIAMS, JARED EDWARD (DDS)
Entity Type:Individual
Prefix:DR
First Name:JARED
Middle Name:EDWARD
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 1:23225 KINGSLAND BLVD
Mailing Address - Street 2:STE 300
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-2890
Mailing Address - Country:US
Mailing Address - Phone:281-395-0400
Mailing Address - Fax:
Practice Address - Street 1:23225 KINGSLAND BLVD.,
Practice Address - Street 2:SUITE 300
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494
Practice Address - Country:US
Practice Address - Phone:281-395-0400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-27
Last Update Date:2014-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX29598122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist