Active NPI
Tiky Kytasha Swain, DDS
- General Practice Dentistry
- Charlotte, NC
National Provider Identifier
1013065796
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 8225
- Practice address
- 8420 University Exec Park Dr
Suite 805
Charlotte, NC 28262-1344 - Phone
- (704) 594-9250
- Fax
- (704) 594-9410
- NPI assigned
- Jan 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health Dentistry | 1223D0001X | 8225 | NC | |
| General Practice Dentistry | 1223G0001X | 8225 | NC | Primary |
Addresses
Primary practice location
8420 University Exec Park Dr
Suite 805
Charlotte, NC 28262-1344
Mailing address
8420 University Exec Park Dr
Suite 805
Charlotte, NC 28262-1344
Phone (704) 594-9250
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5904063 | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8225 | NC | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Doby'S Bridge Dentistry | General Practice | Current | Accepting new patients |
| Gwyn Davis, DMD & Assoc PA | General Practice | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Dentistry
- Indian Land, SC
- NPI 1215575774
-
- General Practice Dentistry
- Charlotte, NC
- NPI 1134181795
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1216771200000",
"number": "1013065796",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8420 UNIVERSITY EXEC PARK DR",
"address_2": "SUITE 805",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282621344",
"telephone_number": "704-594-9250",
"fax_number": "704-594-9410"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8420 UNIVERSITY EXEC PARK DR",
"address_2": "SUITE 805",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282621344",
"telephone_number": "704-594-9250",
"fax_number": "704-594-9410"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SWAIN",
"first_name": "TIKY",
"middle_name": "KYTASHA",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-08",
"last_updated": "2008-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "1223D0001X",
"taxonomy_group": "",
"desc": "Dentist, Dental Public Health",
"state": "NC",
"license": "8225",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NC",
"license": "8225",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5904063",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.