Kyle Roth and Associates III, DDS, PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

KYLE ROTH AND ASSOCIATES III, DDS, PA

Doing business as

Burlington Dental Care

Practice address

2430B S Church St
Burlington, NC 27215-5202

Phone

(336) 513-4474

Fax

(336) 513-4475

NPI assigned

Sep 27, 2006

Organization subpart

No

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

Authorized official

Name

Megan Pridgen

Title

Business Manager

Phone

(919) 696-6394

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Burlington Dental Care Doing business as

Locations

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1285725176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2430B S CHURCH ST",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272155202",
            "telephone_number": "336-513-4474",
            "fax_number": "336-513-4475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2430B S CHURCH ST",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272155202",
            "telephone_number": "336-513-4474",
            "fax_number": "336-513-4475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KYLE ROTH AND ASSOCIATES III, DDS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PRIDGEN",
        "authorized_official_first_name": "MEGAN",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "919-696-6394"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5902666",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Burlington Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Burlington, NC
• Providers in Burlington, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.

Verify at the official NPI Registry.