NPIMap

Organization Active NPI

East Carolina University

Doing business as East Carolina University School of Dental Medicine, CSLC Spruce Pine

  • Dentist
  • Spruce Pine, NC
National Provider Identifier
1144624446
Registry record updated Jul 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
EAST CAROLINA UNIVERSITY
Doing business as
East Carolina University School of Dental Medicine, CSLC Spruce Pine
Practice address
179 Hospital Dr
Spruce Pine, NC 28777-3035
Phone
(828) 765-0110
Fax
(828) 765-0123
NPI assigned
Oct 15, 2014
Last updated
Jul 26, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
EAST CAROLINA UNIVERSITY SCHOOL OF DENTAL MEDICINEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 26, 2024

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

Authorized official

Name
Dr. Dexter Gregory Chadwick, DDS, MSNPI 1396987079
Title
Dean, School of Dental Medicine
Phone
(252) 737-7401

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X NU Primary

Addresses

Primary practice location

179 Hospital Dr
Spruce Pine, NC 28777-3035

Mailing address

179 Hospital Dr
Spruce Pine, NC 28777-3035
Phone (828) 765-0110

Other names 1

  • East Carolina University School of Dental Medicine, CSLC Spruce Pine Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031106000400 NC Part B Supplier - Clinic/Group Practice 0244143246 Receives reassigned benefits from 978 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Greenville, NC; Lillington, NC; Lumberton, NC; Robersonville, NC; Spruce Pine, NC; Sylva, NC; Thomasville, NC; Washington, NC…

Other NPIs on the same Medicare enrollment 13

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 13

National Provider Directory

National Provider Directory
Tax ID family
East Carolina University64 organizations share this tax ID, including this one
Part of
East Carolina University

Organizations with this tax ID in the same state 23

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 23

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1413331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721952000000",
    "number": "1144624446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "179 HOSPITAL DR",
            "city": "SPRUCE PINE",
            "state": "NC",
            "postal_code": "287773035",
            "telephone_number": "828-765-0110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "179 HOSPITAL DR",
            "city": "SPRUCE PINE",
            "state": "NC",
            "postal_code": "287773035",
            "telephone_number": "828-765-0110",
            "fax_number": "828-765-0123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST CAROLINA UNIVERSITY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EAST CAROLINA UNIVERSITY SCHOOL OF DENTAL MEDICINE",
        "enumeration_date": "2014-10-15",
        "last_updated": "2024-07-26",
        "certification_date": "2024-07-26",
        "status": "A",
        "authorized_official_last_name": "CHADWICK",
        "authorized_official_first_name": "DEXTER",
        "authorized_official_middle_name": "GREGORY",
        "authorized_official_title_or_position": "DEAN, SCHOOL OF DENTAL MEDICINE",
        "authorized_official_telephone_number": "252-737-7401",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "East Carolina University School of Dental Medicine, CSLC Spruce Pine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Spruce Pine, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.