Individual provider Active NPI

David P Violette, D.D.S.

  • General Practice Dentistry
  • Shallotte, NC
National Provider Identifier
1255765574
Registry record updated May 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12418 Issued in NC
Practice address
301 S Willis Dr Ste 100
Shallotte, NC 28470-3445
Phone
(910) 754-7700
Fax
(000) 000-0000
NPI assigned
Aug 22, 2013
Last updated
May 24, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 17473 MA
General Practice Dentistry 1223G0001X 12418 NC Primary

Addresses

Primary practice location

301 S Willis Dr Ste 100
Shallotte, NC 28470-3445

Mailing address

301 S Willis Dr Ste 100
Shallotte, NC 28470-3445
Phone (910) 754-7700

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
17473MAMDGeneral Practice Dentistry
12418NCMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
David P. Violette, D.D.S., P.C. General Practice Past Accepting new patients
Sang Hoon Han DDS Inc. PastSince Jun 21, 2022 Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1377129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716508800000",
    "number": "1255765574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 S WILLIS DR STE 100",
            "city": "SHALLOTTE",
            "state": "NC",
            "postal_code": "284703445",
            "telephone_number": "910-754-7700",
            "fax_number": "000-000-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 S WILLIS DR STE 100",
            "city": "SHALLOTTE",
            "state": "NC",
            "postal_code": "284703445",
            "telephone_number": "910-754-7700",
            "fax_number": "000-000-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIOLETTE",
        "first_name": "DAVID",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-08-22",
        "last_updated": "2024-05-24",
        "certification_date": "2024-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "17473",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "12418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shallotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2024; 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.