Individual provider Active NPI

Serafim J Kleitches, D.D.S., P.A.

  • General Practice Dentistry
  • Charlotte, NC
National Provider Identifier
1124112172
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5859 Issued in NC
Practice address
9720 S Tryon St
Suite B
Charlotte, NC 28273-6578
Phone
(704) 588-5600
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 5859 NC Primary

Addresses

Primary practice location

9720 S Tryon St
Suite B
Charlotte, NC 28273-6578

Mailing address

9720 S Tryon St
Suite B
Charlotte, NC 28273-6578
Phone (704) 588-5600

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
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5859NCMDPhysical Therapist

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/9611/brand/1/csg/1/fhir/r4

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124112172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9720 S TRYON ST",
            "address_2": "SUITE B",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282736578",
            "telephone_number": "704-588-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9720 S TRYON ST",
            "address_2": "SUITE B",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282736578",
            "telephone_number": "704-588-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEITCHES",
        "first_name": "SERAFIM",
        "middle_name": "J",
        "credential": "D.D.S., P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "5859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, 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.

Verify at the official NPI Registry.