Provider Demographics
NPI:1245215821
Name:WILLIAMS, RICHARD M (DDS)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:M
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 1:19531 DOCTORS DR
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20874-5262
Mailing Address - Country:US
Mailing Address - Phone:301-540-8844
Mailing Address - Fax:301-540-8845
Practice Address - Street 1:19531 DOCTORS DR
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20874-5262
Practice Address - Country:US
Practice Address - Phone:301-540-8844
Practice Address - Fax:301-540-8845
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-07
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD100131223S0112X, 204E00000X
DCDEN4886204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
No1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD548294100Medicaid