NPIMap

Organization Active NPI

Grimes, Phelps, Pinnix, Betancourt, DDS PLLC

  • Dentist
  • Matthews, NC
National Provider Identifier
1215109426
Registry record updated Mar 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
7648 Issued in NC
Legal business name
GRIMES, PHELPS, PINNIX, BETANCOURT, DDS PLLC
Doing business as
Advanced Dentistry of Blakeney and Matthews
Practice address
510 W John St
Matthews, NC 28105-5353
Phone
(704) 845-1107
Fax
(704) 845-1370
NPI assigned
Mar 27, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2008

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

Authorized official

Name
Dr. Christopher Latham Phelps, DMDNPI 1396828380
Title
Co-President
Phone
(704) 845-1107

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
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 7648 NC Primary

Addresses

Primary practice location

510 W John St
Matthews, NC 28105-5353

Mailing address

510 W John St
Matthews, NC 28105-5353
Phone (704) 845-1107

Other names 1

  • Advanced Dentistry of Blakeney and Matthews Doing business as

National Provider Directory

National Provider Directory

Locations

510 W John St
Matthews, NC 28105
Phone (704) 845-1107

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1206576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206576000000",
    "number": "1215109426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 W JOHN ST",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281055353",
            "telephone_number": "704-845-1107",
            "fax_number": "704-845-1370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 W JOHN ST",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281055353",
            "telephone_number": "704-845-1107",
            "fax_number": "704-845-1370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRIMES, PHELPS, PINNIX, BETANCOURT, DDS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-27",
        "last_updated": "2008-03-27",
        "status": "A",
        "authorized_official_last_name": "PHELPS",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "LATHAM",
        "authorized_official_title_or_position": "CO-PRESIDENT",
        "authorized_official_telephone_number": "704-845-1107",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NC",
            "license": "7648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Dentistry of Blakeney and Matthews",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Matthews, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 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.