Active NPI
Stephanie Atlas Hukill, DDS
- Pediatric Dentistry
- Charlotte, NC
National Provider Identifier
1295097772
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 10304
- Practice address
- 2700 Coltsgate Rd # 204
Charlotte, NC 28211-3799 - Phone
- (704) 749-5700
- NPI assigned
- Jun 12, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 019029731 | IL | |
| Pediatric Dentistry | 1223P0221X | 021002594 | IL | |
| Pediatric Dentistry | 1223P0221X | 10304 | NC | Primary |
Addresses
Primary practice location
2700 Coltsgate Rd # 204
Charlotte, NC 28211-3799
Mailing address
5829 Phyliss Lane
Mint Hill, NC 28227
Phone (704) 790-0590
Other practice location 1
5829 Phyliss Lane
Mint Hill, NC 28227
Phone (704) 790-0590
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 |
|---|---|---|---|
| 10304 | NC | MD | Counselor |
| 019029731 | IL | MD | Dentist |
| 021002594 | IL | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rea Farms Pediatric Dentistry Partnership | Pediatric Dentistry | Current | Accepting new patients |
| Londry, Modlin, Tucker III DDS PLLC | Dentist | Past | 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 and National Provider Directory roles.
-
- Pediatric Dentistry
- Charlotte, NC
- NPI 1205694866
-
- Pediatric Dentistry
- Mint Hill, NC
- NPI 1164281275
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1339459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1554940800000",
"number": "1295097772",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5829 PHYLISS LANE",
"city": "MINT HILL",
"state": "NC",
"postal_code": "28227",
"telephone_number": "704-790-0590"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2700 COLTSGATE RD # 204",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282113799",
"telephone_number": "704-749-5700"
}
],
"practiceLocations": [
{
"address_1": "5829 Phyliss Lane",
"address_purpose": "LOCATION",
"city": "Mint Hill",
"state": "NC",
"postal_code": "28227",
"country_code": "US",
"telephone_number": "704-790-0590",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HUKILL",
"first_name": "STEPHANIE",
"middle_name": "ATLAS",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-06-12",
"last_updated": "2019-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019029731",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "IL",
"license": "021002594",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "NC",
"license": "10304",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.