Active NPI
Serafim J Kleitches, D.D.S., P.A.
- General Practice Dentistry
- Charlotte, NC
National Provider Identifier
1124112172
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 5859
- 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
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 |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 5859 | NC | MD | Physical Therapist |
Interoperability endpoints
- 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.