H.E. Douglas, Jr., DDS, PA

Primary specialty

DentistTaxonomy code 122300000X

License

4760 Issued in NC

Legal business name

H.E. DOUGLAS, JR., DDS, PA

Practice address

4325 Lake Boone TRL
Suite 214
Raleigh, NC 27607-7509

Phone

(919) 782-1151

Fax

(919) 782-1163

NPI assigned

May 29, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Harding Everette Douglas, DDSNPI 1962428854

Title

Owner

Phone

(919) 782-1151

Specialties & licenses 1

Addresses

Practitioners 1

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

• Harding Everette Douglas Jr., DDS

  • General Practice Dentistry
  • Raleigh, NC
  • NPI 1962428854
  NPD (past) Authorized official

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114128063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4325 LAKE BOONE TRL",
            "address_2": "SUITE 214",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276077509",
            "telephone_number": "919-782-1151",
            "fax_number": "919-782-1163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4325 LAKE BOONE TRL",
            "address_2": "SUITE 214",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276077509",
            "telephone_number": "919-782-1151",
            "fax_number": "919-782-1163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "H.E. DOUGLAS, JR., DDS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DOUGLAS",
        "authorized_official_first_name": "HARDING",
        "authorized_official_middle_name": "EVERETTE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "919-782-1151",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NC",
            "license": "4760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Dentist in North Carolina

• 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.