Active NPI
Giles Willis Jr., DDS
- Dentist
- Moncure, NC
National Provider Identifier
1043396948
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 8047
- Practice address
- 7228 Pittsboro-Moncure Road
Moncure, NC 27559-0980 - Phone
- (919) 543-1641
- Fax
- (919) 542-3726
- NPI assigned
- Oct 31, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 8047 | NC | Primary |
Addresses
Primary practice location
7228 Pittsboro-Moncure Road
Moncure, NC 27559-0980
Mailing address
200 Iron Hill Dr
Cary, NC 27519-6931
Phone (919) 372-9548
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8999999 | 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 |
|---|---|---|---|
| 8047 | NC | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lafayette County Dental Clinic, Inc. | Current | Accepting new patients |
Organizations & group practices 1
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.
-
- Dental Clinic/Center
- Stamps, AR
- NPI 1477148542
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1043396948",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 IRON HILL DR",
"city": "CARY",
"state": "NC",
"postal_code": "275196931",
"telephone_number": "919-372-9548"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7228 PITTSBORO-MONCURE ROAD",
"city": "MONCURE",
"state": "NC",
"postal_code": "275590980",
"telephone_number": "919-543-1641",
"fax_number": "919-542-3726"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIS",
"first_name": "GILES",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NC",
"license": "8047",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8999999",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Moncure, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.