Childers & Associates, D.D.S., PLLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

4973 Issued in NC

Legal business name

CHILDERS & ASSOCIATES, D.D.S., PLLC

Practice address

2409 Robeson St
Fayetteville, NC 28305-5549

Phone

(910) 483-9546

Fax

(910) 483-8550

NPI assigned

Apr 17, 2007

Last updated

Oct 21, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Gail Childers

Title

Office Administrator

Phone

(910) 483-9546

Specialties & licenses 1

Addresses

Other identifiers 4

Locations

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224547200000",
    "number": "1316163850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2409 ROBESON ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283055549",
            "telephone_number": "910-483-9546",
            "fax_number": "910-483-8550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2409 ROBESON ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283055549",
            "telephone_number": "910-483-9546",
            "fax_number": "910-483-8550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDERS & ASSOCIATES, D.D.S., PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2008-10-21",
        "status": "A",
        "authorized_official_last_name": "CHILDERS",
        "authorized_official_first_name": "GAIL",
        "authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
        "authorized_official_telephone_number": "910-483-9546",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NC",
            "license": "4973",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890138F",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR. DALE A. CHILDERS",
            "identifier": "467383",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCCI-GROUP",
            "identifier": "955715",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8991553",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• XI Chen, MD
• Pui Cheng
• Chesapeake Rehab Equipment Inc. (ATG Rehab)
• Deyon Chestnut
• Marlena Chieffo
• Dale A Childers, DDS
• Children's Health of Carolina, PA (Children's Health Fayetteville)
• Children's Urgent Care of Fayetteville
• Childrens Acute Care of Fayetteville, P.a.
• Childrens Acute Care PA

• Oral and Maxillofacial Surgery (Dentist) in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Oral and Maxillofacial Surgery (Dentist) in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 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.