Individual provider Active NPI

Tameka Nicole Attaway, D.D.S.

  • Dentist
  • Charlotte, NC
National Provider Identifier
1205240819
Registry record updated Aug 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
9772 Issued in NC
Practice address
2120 Keller Ave
None
Charlotte, NC 28216-4632
Phone
(704) 392-9357
Fax
(704) 392-9304
NPI assigned
Jun 12, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 9772 NC Primary

Addresses

Primary practice location

2120 Keller Ave
None
Charlotte, NC 28216-4632

Mailing address

2120 Keller Ave
None
Charlotte, NC 28216-4632
Phone (704) 392-9357

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150810002185 NC Order and Referring Only - DentistPractitioner - Dentist 9335454040

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1402531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406851200000",
    "number": "1205240819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2120 KELLER AVE",
            "address_2": "NONE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282164632",
            "telephone_number": "704-392-9357",
            "fax_number": "704-392-9304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 KELLER AVE",
            "address_2": "NONE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282164632",
            "telephone_number": "704-392-9357",
            "fax_number": "704-392-9304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATTAWAY",
        "first_name": "TAMEKA",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-12",
        "last_updated": "2014-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "9772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.