Provider Demographics
NPI:1932264876
Name:SESSOMS, WILLIAM DAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:DAN
Last Name:SESSOMS
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 1:4525 DAWSON DRIVE
Mailing Address - Street 2:
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72116
Mailing Address - Country:US
Mailing Address - Phone:501-412-4029
Mailing Address - Fax:
Practice Address - Street 1:2702 S MAIN ST
Practice Address - Street 2:
Practice Address - City:STUTTGART
Practice Address - State:AR
Practice Address - Zip Code:72160-7038
Practice Address - Country:US
Practice Address - Phone:870-673-7181
Practice Address - Fax:870-672-4554
Is Sole Proprietor?:No
Enumeration Date:2006-12-22
Last Update Date:2018-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR24451223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR58714OtherBLUE CROSS BLUE SHIELD
AR167623608Medicaid