Boksoon Brenda Gong, D.D.S.
Individual provider Active NPI General Practice Dentistry · Angier, NC
NPI 1124439559 · NPPES record last updated May 20, 2014
Key facts
- NPI
- 1124439559
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 9718 (NC)
- Practice address
- 12 N Broad St E
Angier, NC 27501-8964 - Phone
- (919) 538-2298
- NPI assigned
- May 20, 2014
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Angier Dental | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 9718 | NC | Yes |
Addresses
Primary practice location
12 N Broad St E
Angier, NC 27501-8964
Mailing address
12 N Broad St E
Angier, NC 27501-8964
Phone (919) 538-2298
Other providers in Angier, NC
- Tauscha Alyse Gerald
- Jamila German
- Shellvia Cearnal Gill
- Whitney Johnson Gilmore
- Golden Spine Chiropractic PLLC
- Scott Jason Gordon
- Julie Gray
- Donna Green
- Tambryme Hamilton-Simmons
- Hart Integrated Wellness Services, PLLC
All providers in Angier, NC · General Practice Dentistry in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 20, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.