Donald Richard Fortner Jr., DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5908 Issued in NC

Practice address

1834 Jake Alexander Blvd West
Suite 504
Salisbury, NC 28147

Phone

(704) 636-1848

Fax

(704) 636-4890

NPI assigned

Jun 28, 2006

Last updated

Feb 9, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Tyler Brown DDS PLLC

  • General Practice Dentistry
  • Salisbury, NC
  • NPI 1417742941
  NPD
• Donald R Fortner Jr DMD

  • General Practice Dentistry
  • Salisbury, NC
  • NPI 1205868080
  NPD (past)

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234137600000",
    "number": "1316974827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1834 JAKE ALEXANDER BLVD WEST",
            "address_2": "SUITE 504",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "28147",
            "telephone_number": "704-636-1848",
            "fax_number": "704-636-4890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1834 JAKE ALEXANDER BLVD WEST",
            "address_2": "SUITE 504",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "28147",
            "telephone_number": "704-636-1848",
            "fax_number": "704-636-4890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORTNER",
        "first_name": "DONALD",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2009-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "5908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Food Lion LLC (Food Lion Pharmacy)
• Food Lion LLC
• Vivian Kimberly Forbes
• Antoinette Ford
• Samuel L. Fort
• Sandy Lee Fortson, PTA
• Audassi Yvonne Foster
• Diana Marie Foster, MSN, APRN, FNP-C
• Bertrand Fote, MD
• Foundation Health Systems LLC (Novant Health Rehabilitation Center)

• General Practice Dentistry in Salisbury, NC
• Providers in Salisbury, 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 Feb 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.