NPIMap

Organization Active NPI

A Darren Sholar, DDS,PA

Doing business as Southland Dental Care

  • General Practice Dentistry
  • Wallace, NC
National Provider Identifier
1053561555
Registry record updated Jun 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6268 Issued in NC
Legal business name
A DARREN SHOLAR, DDS,PA
Doing business as
Southland Dental Care
Practice address
522 S Norwood St
Wallace, NC 28466-1620
Phone
(910) 285-7800
Fax
(910) 285-6097
NPI assigned
Sep 22, 2008
Last updated
Jun 11, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2020

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

Authorized official

Name
Dr. Axon Darren Sholar, DDSNPI 1659317394
Title
President/Ownder
Phone
(910) 285-7800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 6268 NC Primary

Addresses

Primary practice location

522 S Norwood St
Wallace, NC 28466-1620

Mailing address

522 S Norwood St
Wallace, NC 28466-1620
Phone (910) 285-7800

Other identifiers 4

IdentifierTypeStateIssuer
385397OtherNCTRIGON
1680308OtherNCUNITED CONCORDIA
97800OtherNCBCBS
8997800MedicaidNC

Other names 1

  • Southland Dental Care Doing business as

National Provider Directory

National Provider Directory

Locations

522 S Norwood St
Wallace, NC 28466
Phone (910) 285-7800

Practitioners & affiliated clinicians

Practitioners 2

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": "1222041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591833600000",
    "number": "1053561555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "522 S NORWOOD ST",
            "city": "WALLACE",
            "state": "NC",
            "postal_code": "284661620",
            "telephone_number": "910-285-7800",
            "fax_number": "910-285-6097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "522 S NORWOOD ST",
            "city": "WALLACE",
            "state": "NC",
            "postal_code": "284661620",
            "telephone_number": "910-285-7800",
            "fax_number": "910-285-6097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A DARREN SHOLAR, DDS,PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-22",
        "last_updated": "2020-06-11",
        "certification_date": "2020-06-11",
        "status": "A",
        "authorized_official_last_name": "SHOLAR",
        "authorized_official_first_name": "AXON",
        "authorized_official_middle_name": "DARREN",
        "authorized_official_title_or_position": "PRESIDENT/OWNDER",
        "authorized_official_telephone_number": "910-285-7800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "6268",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIGON",
            "identifier": "385397",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "1680308",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "97800",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8997800",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southland Dental Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Southland Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wallace, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 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.