NPIMap

Organization Active NPI

Mark a Odom DDS PA

  • Endodontics
  • Cary, NC
National Provider Identifier
1306018080
Registry record updated Apr 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
5622 Issued in NC
Legal business name
MARK A ODOM DDS PA
Practice address
1400 Crescent Green
Suite 200
Cary, NC 27518-8118
Phone
(919) 233-8830
Fax
(919) 233-7168
NPI assigned
Apr 2, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2008

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

Authorized official

Name
Dr. Mark A Odom, DDSNPI 1952497711
Title
President Endodontist
Phone
(919) 233-8830

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223E0200X 5622 NC Primary
EndodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223E0200X 3995 LA

Addresses

Primary practice location

1400 Crescent Green
Suite 200
Cary, NC 27518-8118

Mailing address

1400 Crescent Green
Suite 200
Cary, NC 27518-8118
Phone (919) 233-8830

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1207094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207094400000",
    "number": "1306018080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 CRESCENT GREEN",
            "address_2": "SUITE 200",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275188118",
            "telephone_number": "919-233-8830",
            "fax_number": "919-233-7168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 CRESCENT GREEN",
            "address_2": "SUITE 200",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275188118",
            "telephone_number": "919-233-8830",
            "fax_number": "919-233-7168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK A ODOM DDS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-02",
        "last_updated": "2008-04-02",
        "status": "A",
        "authorized_official_last_name": "ODOM",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT ENDODONTIST",
        "authorized_official_telephone_number": "919-233-8830",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": "NC",
            "license": "5622",
            "primary": true
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": "LA",
            "license": "3995",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cary, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2008; 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.