Active NPI
Nicholas Cornwell, DMD
- General Practice Dentistry
- Lewisville, NC
National Provider Identifier
1265050892
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 11886
- Practice address
- 6570 Shallowford Rd
Lewisville, NC 27023-8651 - Phone
- (336) 945-5555
- NPI assigned
- Jul 9, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 11886 | NC | Primary |
Addresses
Primary practice location
6570 Shallowford Rd
Lewisville, NC 27023-8651
Mailing address
97604 Franklin RDG
Chapel Hill, NC 27517-8357
Phone (908) 963-1885
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11886 | NC | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1594252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1594252800000",
"number": "1265050892",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "97604 FRANKLIN RDG",
"city": "CHAPEL HILL",
"state": "NC",
"postal_code": "275178357",
"telephone_number": "908-963-1885"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6570 SHALLOWFORD RD",
"city": "LEWISVILLE",
"state": "NC",
"postal_code": "270238651",
"telephone_number": "336-945-5555"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORNWELL",
"first_name": "NICHOLAS",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-07-09",
"last_updated": "2020-07-09",
"certification_date": "2020-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NC",
"license": "11886",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lewisville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.