Individual provider Active NPI

Terry Edward Callison, D.D.S., M.S.

  • Dentist
  • Cornelius, NC
National Provider Identifier
1255427035
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
3289 Issued in WV
Practice address
19410 Jetton Road
Suite 210
Cornelius, NC 28031
Phone
(704) 237-9022
Fax
(704) 237-9025
NPI assigned
Oct 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 3289 WV Primary
Endodontics 1223E0200X 7706 NC

Addresses

Primary practice location

19410 Jetton Road
Suite 210
Cornelius, NC 28031

Mailing address

19410 Jetton Road
Suite 210
Cornelius, NC 28031
Phone (704) 237-9022

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
7706NCMDPeriodontist
3289WVMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Terry E. Callison, D.D.S., M.S., P.a. Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1255427035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19410 JETTON ROAD",
            "address_2": "SUITE 210",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "28031",
            "telephone_number": "704-237-9022",
            "fax_number": "704-237-9025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19410 JETTON ROAD",
            "address_2": "SUITE 210",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "28031",
            "telephone_number": "704-237-9022",
            "fax_number": "704-237-9025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALLISON",
        "first_name": "TERRY",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WV",
            "license": "3289",
            "primary": true
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "NC",
            "license": "7706",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cornelius, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.