NPIMap

Organization Active NPI

Phillippi and Kwon Dentistry Partnership

  • General Practice Dentistry
  • Charlotte, NC
National Provider Identifier
1326077694
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5170 Issued in NC
Legal business name
PHILLIPPI AND KWON DENTISTRY PARTNERSHIP
Practice address
2770 E WT Harris Blvd
Suite 102
Charlotte, NC 28213-4096
Phone
(704) 509-4513
Fax
(704) 509-4516
NPI assigned
Jun 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Paul Jeffrey Phillippi, D.D.S.NPI 1407880875
Title
General Partner
Phone
(704) 509-4513

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 5170 NC Primary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 6838 NC

Addresses

Primary practice location

2770 E WT Harris Blvd
Suite 102
Charlotte, NC 28213-4096

Mailing address

2770 E WT Harris Blvd
Suite 102
Charlotte, NC 28213-4096
Phone (704) 509-4513

Other identifiers 1

IdentifierTypeStateIssuer
89014V2MedicaidNC

National Provider Directory

National Provider Directory

Locations

2770 E Wt Harris Blvd
Ste 102
Charlotte, NC 28213
Phone (704) 509-4513

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1326077694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2770 E WT HARRIS BLVD",
            "address_2": "SUITE 102",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282134096",
            "telephone_number": "704-509-4513",
            "fax_number": "704-509-4516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2770 E WT HARRIS BLVD",
            "address_2": "SUITE 102",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282134096",
            "telephone_number": "704-509-4513",
            "fax_number": "704-509-4516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILLIPPI AND KWON DENTISTRY PARTNERSHIP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PHILLIPPI",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "JEFFREY",
        "authorized_official_title_or_position": "GENERAL PARTNER",
        "authorized_official_telephone_number": "704-509-4513",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "5170",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "6838",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89014V2",
            "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 Aug 22, 2020; 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.