Provider Demographics
NPI:1346324001
Name:WILLIAMS, ROBIN (DMD)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2650 BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:BILOXI
Mailing Address - State:MS
Mailing Address - Zip Code:39531-4517
Mailing Address - Country:US
Mailing Address - Phone:228-400-4722
Mailing Address - Fax:
Practice Address - Street 1:2650 BEACH BLVD
Practice Address - Street 2:
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39531-4517
Practice Address - Country:US
Practice Address - Phone:228-400-4722
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS4334-221223X0400X
CA510111223X0400X
MSOR-6028-221223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA51011OtherDENTAL BOARD OF CALIFORNI
MS4334-22OtherDENTAL BOARD MISSISSIPPI
NY051724OtherNYSED/OP
MSOR-6028-22OtherDENTAL BOARD MISSISSIPPI SPECIALTY