NPIMap

Organization Active NPI

DRS Mabe & Mabe PA

  • Dentist
  • Walnut Cove, NC
National Provider Identifier
1093726929
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
104509 Issued in NC
Legal business name
DRS MABE & MABE PA
Practice address
1218 N Main Street
Walnut Cove, NC 27052
Phone
(336) 591-4303
Fax
(336) 591-4516
NPI assigned
Aug 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Tim Mabe, DDSNPI 1013025352
Title
President
Phone
(336) 591-4303

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 104509 NC Primary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 104574 NC

Addresses

Primary practice location

1218 N Main Street
Walnut Cove, NC 27052

Mailing address

PO Box 648
Walnut Cove, NC 27052
Phone (336) 591-4303

Other identifiers 1

IdentifierTypeStateIssuer
8902103MedicaidNC

National Provider Directory

National Provider Directory

Locations

1218 N Main St
Walnut Cove, NC 27052
Phone (336) 591-4303

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1093726929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 648",
            "city": "WALNUT COVE",
            "state": "NC",
            "postal_code": "27052",
            "telephone_number": "336-591-4303",
            "fax_number": "336-591-4516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1218 N MAIN STREET",
            "city": "WALNUT COVE",
            "state": "NC",
            "postal_code": "27052",
            "telephone_number": "336-591-4303",
            "fax_number": "336-591-4516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRS MABE & MABE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MABE",
        "authorized_official_first_name": "TIM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "336-591-4303",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NC",
            "license": "104509",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NC",
            "license": "104574",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8902103",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Cove, 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.

Verify at the official NPI Registry.