Provider Demographics
NPI:1215028535
Name:EDWARDS, WILLIAM FELIX (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:FELIX
Last Name:EDWARDS
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 1:1313 CLOVE RD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10301-4338
Mailing Address - Country:US
Mailing Address - Phone:718-273-1101
Mailing Address - Fax:718-273-0308
Practice Address - Street 1:1313 CLOVE RD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10301-4338
Practice Address - Country:US
Practice Address - Phone:718-273-1101
Practice Address - Fax:718-273-0308
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY04554211223D0001X
NJ22DI01934400122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentist
No1223D0001XDental ProvidersDentistDental Public HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02353313Medicaid