NPIMap

Organization Active NPI

Brian L Maynor D.D.S., PLLC

Doing business as Crosscreek Family Dentistry

  • General Practice Dentistry
  • Roanoke Rapids, NC
National Provider Identifier
1194212456
Registry record updated Apr 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
10438 Issued in NC
Legal business name
BRIAN L MAYNOR D.D.S., PLLC
Doing business as
Crosscreek Family Dentistry
Practice address
523 NC Highway 125
Roanoke Rapids, NC 27870-6447
Phone
(252) 533-9300
NPI assigned
Apr 21, 2018
Last updated
Apr 21, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2018

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

Authorized official

Name
Dr. Brian Lanier Maynor, DDSNPI 1952782716
Title
Dentist
Phone
(252) 533-9300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 10438 NC Primary

Addresses

Primary practice location

523 NC Highway 125
Roanoke Rapids, NC 27870-6447

Mailing address

523 NC Highway 125
Roanoke Rapids, NC 27870-6447
Phone (252) 533-9300

Other names 1

  • Crosscreek Family Dentistry Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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": "1524268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524268800000",
    "number": "1194212456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "523 NC HIGHWAY 125",
            "city": "ROANOKE RAPIDS",
            "state": "NC",
            "postal_code": "278706447",
            "telephone_number": "252-533-9300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "523 NC HIGHWAY 125",
            "city": "ROANOKE RAPIDS",
            "state": "NC",
            "postal_code": "278706447",
            "telephone_number": "252-533-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIAN L MAYNOR D.D.S., PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-21",
        "last_updated": "2018-04-21",
        "status": "A",
        "authorized_official_last_name": "MAYNOR",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "LANIER",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "252-533-9300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "10438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crosscreek Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Crosscreek Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Roanoke Rapids, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 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.