Active NPI
Nicholas James Penna D.D.S.,P.a.
- Orthodontics and Dentofacial Orthopedics Dentistry
- Salisbury, NC
National Provider Identifier
1033210380
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- NC4936
- Legal business name
- NICHOLAS JAMES PENNA D.D.S.,P.A.
- Practice address
- 1819 Brenner Ave
Salisbury, NC 28144-2519 - Phone
- (704) 633-5942
- Fax
- (704) 639-0237
- NPI assigned
- Sep 26, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Nicholas James Penna, D.D.S.
- Title
- President
- Phone
- (704) 633-5942
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | NC4936 | NC | Primary |
Addresses
Primary practice location
1819 Brenner Ave
Salisbury, NC 28144-2519
Mailing address
1819 Brenner Ave
Salisbury, NC 28144-2519
Phone (704) 633-5942
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8996806 | Medicaid | NC | |
| 899019P | Medicaid | NC |
National Provider Directory
National Provider DirectoryLocations
1819 Brenner Ave
Salisbury, NC 28144
Phone (704) 633-5942
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Orthodontics and Dentofacial Orthopedics Dentistry
- Salisbury, NC
- NPI 1689737496
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159228800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1033210380",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1819 BRENNER AVE",
"city": "SALISBURY",
"state": "NC",
"postal_code": "281442519",
"telephone_number": "704-633-5942",
"fax_number": "704-639-0237"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1819 BRENNER AVE",
"city": "SALISBURY",
"state": "NC",
"postal_code": "281442519",
"telephone_number": "704-633-5942",
"fax_number": "704-639-0237"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NICHOLAS JAMES PENNA D.D.S.,P.A.",
"organizational_subpart": "NO",
"enumeration_date": "2006-09-26",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "PENNA",
"authorized_official_first_name": "NICHOLAS",
"authorized_official_middle_name": "JAMES",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "704-633-5942",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "D.D.S."
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "NC",
"license": "NC4936",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8996806",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "899019P",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Salisbury, 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.