Provider Demographics
NPI:1174788400
Name:WILLIAMS, FRENDA BRIGETTE (DDS)
Entity type:Individual
Prefix:DR
First Name:FRENDA
Middle Name:BRIGETTE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 SOUTH LAKE AVENUE
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-2615
Mailing Address - Country:US
Mailing Address - Phone:626-795-6855
Mailing Address - Fax:
Practice Address - Street 1:2015 W 81ST ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90047
Practice Address - Country:US
Practice Address - Phone:424-202-7252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-25
Last Update Date:2008-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44379122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist