Provider Demographics
NPI:1659633782
Name:WILLIAMS, ANGELA M (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:M
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6816 N MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64118-1038
Mailing Address - Country:US
Mailing Address - Phone:816-807-7842
Mailing Address - Fax:
Practice Address - Street 1:11005 W 60TH ST
Practice Address - Street 2:STE 180
Practice Address - City:SHAWNEE
Practice Address - State:KS
Practice Address - Zip Code:66203-2716
Practice Address - Country:US
Practice Address - Phone:913-631-0110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-14
Last Update Date:2016-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20110153221223X0400X
KS610981223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics