Bluewave Dentistry

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

8379 Issued in NC

Legal business name

BLUEWAVE DENTISTRY

Practice address

1300 S Dickinson Dr
Leland, NC 28451-6430

Phone

(910) 383-2615

Fax

(910) 383-2618

NPI assigned

May 9, 2018

Last updated

May 9, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kelly Davis

Title

Practice Manager

Phone

(910) 383-2615

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Charles Richardson Biggerstaff, DDS, PHARMD

  • General Practice Dentistry
  • Leland, NC
  • NPI 1790987774
  NPD (past)
• David Vurnakes, D.M.D.

  • General Practice Dentistry
  • Leland, NC
  • NPI 1164879979
  NPD (past)

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

{
    "created_epoch": "1525824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525824000000",
    "number": "1124517719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 S DICKINSON DR",
            "city": "LELAND",
            "state": "NC",
            "postal_code": "284516430",
            "telephone_number": "910-383-2615",
            "fax_number": "910-383-2618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 S DICKINSON DR",
            "city": "LELAND",
            "state": "NC",
            "postal_code": "284516430",
            "telephone_number": "910-383-2615",
            "fax_number": "910-383-2618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUEWAVE DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-09",
        "last_updated": "2018-05-09",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "910-383-2615"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "8379",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC STATE BOARD OF DENTAL EXAMINERS",
            "identifier": "7812",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC SATE BOARD OF DENTAL EXAMINERS",
            "identifier": "8379",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charles Richardson Biggerstaff, DDS, PHARMD
• Jennifer Suzanne Blevins, NP
• Bloomia Therapy Services
• Blossom Counseling Center PLLC
• Bluewater Dermatology and Skin Cancer Center PA
• Michelle Becky Blyumin, DDS
• Anette Bodoky, M.D.
• John D. Boldizar, M.D.
• Linda Bombach, FNP
• Haydee Bourne, FNP

• General Practice Dentistry in Leland, NC
• Providers in Leland, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2018; 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.