NPIMap

Organization Active NPI

Paul E Rudnicke DDS PA

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Winston Salem, NC
National Provider Identifier
1215059597
Registry record updated Sep 3, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
7543 Issued in NC
Legal business name
PAUL E RUDNICKE DDS PA
Practice address
1704 S Hawthorne Rd
Winston Salem, NC 27103-4016
Phone
(336) 768-3040
NPI assigned
Apr 6, 2007
Last updated
Sep 3, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2007

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

Authorized official

Name
Paul E RudnickeNPI 1043332323
Title
President
Phone
(336) 768-3040

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
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 7543 NC Primary

Addresses

Primary practice location

1704 S Hawthorne Rd
Winston Salem, NC 27103-4016

Mailing address

1704 S Hawthorne Rd
Winston Salem, NC 27103-4016

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1175817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188777600000",
    "number": "1215059597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1704 S HAWTHORNE RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271034016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1704 S HAWTHORNE RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271034016",
            "telephone_number": "336-768-3040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL E RUDNICKE DDS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-06",
        "last_updated": "2007-09-03",
        "status": "A",
        "authorized_official_last_name": "RUDNICKE",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "336-768-3040"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NC",
            "license": "7543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2007; 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.