Active NPI
Chase T Prettyman, D.D.S., M.S.D
- Orthodontics and Dentofacial Orthopedics Dentistry
- Charlotte, NC
National Provider Identifier
1306153796
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 9028
- Practice address
- 202 E Woodlawn Rd
Ste 144a
Charlotte, NC 28217-2213 - Phone
- (704) 247-9150
- Fax
- (704) 529-1420
- NPI assigned
- Sep 7, 2010
- 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 |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 9028 | NC | Primary |
Addresses
Primary practice location
202 E Woodlawn Rd
Ste 144a
Charlotte, NC 28217-2213
Mailing address
202 E Woodlawn Rd
Ste 114
Charlotte, NC 28217-2213
Phone (704) 522-1550
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5915841 | Medicaid | NC |
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 |
|---|---|---|---|
| 9028 | NC | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| John Walsh DDS PA | Past | Accepting new patients | |
| Hammock, DMD & Lotakis, DDS IX, PLLC | Past | Accepting new patients | |
| John Walsh DDS PA | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Dentist
- Charlotte, NC
- NPI 1730646241
-
- General Practice Dentistry
- Statesville, NC
- NPI 1528260767
-
- General Practice Dentistry
- Charlotte, NC
- NPI 1538410873
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1283817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1343692800000",
"number": "1306153796",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "202 E WOODLAWN RD",
"address_2": "STE 114",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282172213",
"telephone_number": "704-522-1550",
"fax_number": "704-522-1558"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "202 E WOODLAWN RD",
"address_2": "STE 144A",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282172213",
"telephone_number": "704-247-9150",
"fax_number": "704-529-1420"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRETTYMAN",
"first_name": "CHASE",
"middle_name": "T",
"name_prefix": "Dr.",
"credential": "D.D.S., M.S.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-09-07",
"last_updated": "2012-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "NC",
"license": "9028",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5915841",
"state": "NC"
}
],
"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 Jul 31, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.