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Deactivated NPI 1609989961 Deactivated / Inactive NPI Male Practitioner

Dr. Bruce Mosby Williams , DDS

Dentist • Shakopee, MN

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Bruce Williams has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date August 17, 2006
NPI Deactivation Date September 15, 2022
Total Practice Duration ~16 Years of Practice (2006 – 2022)

Professional Overview & Biography Verified Profile Summary

Dr. Bruce Williams, DDS was a registered Dentist practicing in Shakopee, MN. Throughout an active medical career spanning 16 years, Dr. Williams provided care at the practice location at 1759 17TH AVE E until profile deactivation on 2022-09-15.

Practice Location & Contact Primary Location

Practice Address

1759 17th Ave E

Shakopee, MN 553793372

Telephone 2175408250
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Shakopee, MN

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 18.6 Yrs
Regional Practice Density
9 Specialists

Practicing in Shakopee, MN (1863 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2026-01-30
Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

State License MO 2025012199

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Dentist

NUCC Taxonomy Code: 122300000X

State License MN D15402

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Dentist - General Practice

NUCC Taxonomy Code: 1223G0001X

State License OK 4946

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Secondary Practice Locations

3177 E 146th Pl S

Bixby, OK 740088046

Phone: 4056279113

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
NPI 1649475773

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

13 Historical Events
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Updated Business Mailing Address January 30, 2026

Registered at 8603 NORTH OAK TRAFFIC WAY, KANSAS CITY, MO 64155 (Tel: 4056279113)

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Medical Taxonomy / Specialty Registered (Primary Specialty) January 30, 2026

Dentist (License #2025012199 in MO)

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Updated Practice Location December 01, 2025

Registered at 1759 17TH AVE E, SHAKOPEE, MN 553793372 (Tel: 2175408250)

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Updated Business Mailing Address December 01, 2025

Registered at 1759 17TH AVE E, SHAKOPEE, MN 553793372 (Tel: 4056279113)

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Medical Taxonomy / Specialty Registered (Primary Specialty) December 01, 2025

Dentist (License #D15402 in MN)

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NPI Profile Reactivated September 30, 2022

Record officially reactivated for active practice on September 30, 2022

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NPI Profile Deactivated September 15, 2022

Record deactivated on September 15, 2022

NPI Profile Active April 07, 2014

NPI status registered as active in NPPES database

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Updated Practice Location April 07, 2014

Registered at 3177 E 146TH PL S, BIXBY, OK 740088046 (Tel: 4056279113)

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Updated Business Mailing Address April 07, 2014

Registered at 3177 E 146TH PL S, BIXBY, OK 740088046 (Tel: 4056279113)

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Provider Name / Credentials Updated April 07, 2014

Recorded as BRUCE WILLIAMS, D.D.S

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Medical Taxonomy / Specialty Registered (Primary Specialty) April 07, 2014

Dentist (License #4946 in OK)

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Initial NPI Registration & Enumeration August 17, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1609989961
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 17, 2006
Last Update: January 30, 2026
Deactivation Date: September 15, 2022
Sole Proprietor: Yes

Mailing Address

8603 North Oak Traffic Way

Kansas City, MO 64155

Phone: 4056279113

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.