Active NPI
Mollye Vick, DDS
- Dentist
- Concord, NC
National Provider Identifier
1124086442
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 7049
- Practice address
- 5641 Poplar Tent Rd
Ste 203
Concord, NC 28027 - Phone
- (704) 793-4211
- Fax
- (704) 793-4210
- NPI assigned
- May 3, 2006
- Sex
- Female
- 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 | 7049 | NC | Primary |
Addresses
Primary practice location
5641 Poplar Tent Rd
Ste 203
Concord, NC 28027
Mailing address
5641 Poplar Tent Rd
Ste 203
Concord, NC 28027
Phone (704) 793-4211
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 |
|---|---|---|---|
| 7049 | NC | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Farzaneh Keshmiri DDS PA | Past | 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.
-
- General Practice Dentistry
- Concord, NC
- NPI 1336107291
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146614400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1124086442",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5641 POPLAR TENT RD",
"address_2": "STE 203",
"city": "CONCORD",
"state": "NC",
"postal_code": "28027",
"telephone_number": "704-793-4211",
"fax_number": "704-793-4210"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5641 POPLAR TENT RD",
"address_2": "STE 203",
"city": "CONCORD",
"state": "NC",
"postal_code": "28027",
"telephone_number": "704-793-4211",
"fax_number": "704-793-4210"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VICK",
"first_name": "MOLLYE",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-03",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NC",
"license": "7049",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Concord, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.