NPIMap

Organization Active NPI

Dr David G Dickerhoff DDS & Associates PA

  • Dental Clinic/Center
  • Spring Lake, NC
National Provider Identifier
1003992223
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
DR DAVID G DICKERHOFF DDS & ASSOCIATES PA
Practice address
103 Superior Drive
Spring Lake, NC 28390
Phone
(910) 497-3200
Fax
(910) 497-2209
NPI assigned
Oct 31, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Angela Michele Carr Finch
Title
Office Manager
Phone
(910) 497-3200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X NU Primary

Addresses

Primary practice location

103 Superior Drive
Spring Lake, NC 28390

Mailing address

103 Superior Drive
Spring Lake, NC 28390

Other identifiers 2

IdentifierTypeStateIssuer
714367OtherUNITED CONCORDIA
0137YOtherBLUE CROSS BLUE SHIELD

Other names 1

  • Spring Lake Dental Group Other name

National Provider Directory

National Provider Directory

Locations

103 Superior Dr
Spring Lake, NC 28390
Phone (910) 497-3200

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003992223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 SUPERIOR DRIVE",
            "city": "SPRING LAKE",
            "state": "NC",
            "postal_code": "28390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 SUPERIOR DRIVE",
            "city": "SPRING LAKE",
            "state": "NC",
            "postal_code": "28390",
            "telephone_number": "910-497-3200",
            "fax_number": "910-497-2209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR DAVID G DICKERHOFF DDS & ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CARR FINCH",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "MICHELE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "910-497-3200",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "714367",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0137Y",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Spring Lake Dental Group",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Spring Lake, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.