Pediatric Dentistry of Wesley Chapel

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

PEDIATRIC DENTISTRY OF WESLEY CHAPEL

Practice address

5941 Weddington Rd
Suite 103
Wesley Chapel, NC 28104-6289

Phone

(704) 496-9246

Fax

(704) 684-8059

NPI assigned

Sep 26, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Scott Goodman

Title

President

Phone

(704) 496-9246

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1411689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411689600000",
    "number": "1134521768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5941 WEDDINGTON RD",
            "address_2": "SUITE 103",
            "city": "WESLEY CHAPEL",
            "state": "NC",
            "postal_code": "281046289",
            "telephone_number": "704-496-9246",
            "fax_number": "704-684-8059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5941 WEDDINGTON RD",
            "address_2": "SUITE 103",
            "city": "WESLEY CHAPEL",
            "state": "NC",
            "postal_code": "281046289",
            "telephone_number": "704-496-9246",
            "fax_number": "704-684-8059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC DENTISTRY OF WESLEY CHAPEL",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-26",
        "last_updated": "2014-09-26",
        "status": "A",
        "authorized_official_last_name": "GOODMAN",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "704-496-9246",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Novant Health Medical Group, LLC
• Novant Health Medical Group, LLC
• Novant Health Medical Group, LLC
• Tiffany Madsen Ohta, MD
• Roshni Parag Patel, MD
• Larry F Perkins, DDS, PA
• Thomas Faran Pittman, MD
• Publix North Carolina LP
• Ricahrd E. Graham DMD PLLC
• Charissa Joy Richard, DO

• Pediatric Dentistry in Wesley Chapel, NC
• Providers in Wesley Chapel, NC by specialty
• Pediatric Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2014; 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.