Organization Active NPI

Sharon Cobham DDS and Nicole Lecann DDS IV PA

  • General Practice Dentistry
  • Raleigh, NC
National Provider Identifier
1154484228
Registry record updated May 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7000 Issued in NC
Legal business name
SHARON COBHAM DDS AND NICOLE LECANN DDS IV PA
Practice address
4814 Six Forks Rd
Suite 102
Raleigh, NC 27609
Phone
(919) 783-5550
Fax
(919) 791-1990
NPI assigned
Dec 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2008

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

Authorized official

Name
Dr. Nicole Lecann, DDS
Title
Owner
Phone
(919) 789-8682

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 6970 NC
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 7000 NC Primary

Addresses

Primary practice location

4814 Six Forks Rd
Suite 102
Raleigh, NC 27609

Mailing address

4814 Six Forks Rd
Suite 102
Raleigh, NC 27609
Phone (919) 783-5550

Other identifiers 2

IdentifierTypeStateIssuer
89014NTMedicaidNC
014NTOtherNCNCHC

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209686400000",
    "number": "1154484228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4814 SIX FORKS RD",
            "address_2": "SUITE 102",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "27609",
            "telephone_number": "919-783-5550",
            "fax_number": "919-791-1990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4814 SIX FORKS RD",
            "address_2": "SUITE 102",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "27609",
            "telephone_number": "919-783-5550",
            "fax_number": "919-791-1990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHARON COBHAM DDS AND NICOLE LECANN DDS IV PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-19",
        "last_updated": "2008-05-02",
        "status": "A",
        "authorized_official_last_name": "LECANN",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "919-789-8682",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "6970",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "7000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89014NT",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCHC",
            "identifier": "014NT",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2008; 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.