Individual provider Active NPI

David Wayne Paquette, DMD, MPH, DMSC

  • Periodontics
  • Chapel Hill, NC
National Provider Identifier
1043374135
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
0021 Issued in NC
Practice address
101 Brauer Hall CB # 7450
Chapel Hill, NC 27599-7450
Phone
(919) 966-1221
NPI assigned
Dec 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 0021 NC Primary
Periodontics 1223P0300X 17520 MA

Addresses

Primary practice location

101 Brauer Hall CB # 7450
Chapel Hill, NC 27599-7450

Mailing address

401 Clayton Rd
Chapel Hill, NC 27514-7613

Other identifiers 1

IdentifierTypeStateIssuer
89-96589MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180529001089 NC Practitioner - Dentist 5496045635 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
17520MAMDPeriodontist
0021NCMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
East Carolina University CurrentSince Mar 5, 2018 Accepting new patients
East Carolina University CurrentSince Mar 5, 2018 Accepting new patients
East Carolina University Current Accepting new patients
Dental Faculty Practice Periodontics PastSince Jan 2, 1998 Accepting new patients

Locations

1851 Macgregor Downs Rd
Greenville, NC 27834
Phone (252) 737-7000

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043374135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 CLAYTON RD",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275147613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 BRAUER HALL CB # 7450",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275997450",
            "telephone_number": "919-966-1221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAQUETTE",
        "first_name": "DAVID",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "DMD, MPH, DMSC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NC",
            "license": "0021",
            "primary": true
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "MA",
            "license": "17520",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89-96589",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chapel Hill, NC

Sources for this page

Verify at the official NPI Registry.