NPIMap

Organization Active NPI

Firsthealth Dental Care Center

  • Dental Clinic/Center
  • Raeford, NC
National Provider Identifier
1376513622
Registry record updated Dec 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
H0100 Issued in NC
Legal business name
FIRSTHEALTH DENTAL CARE CENTER
Practice address
314 Teal Dr
Raeford, NC 28376-2528
Phone
(910) 904-7450
Fax
(910) 904-7474
NPI assigned
Jan 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2024

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

Authorized official

Name
Mickey Foster
Title
Ceo
Phone
(910) 715-4473

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X H0100 NC Primary

Addresses

Primary practice location

314 Teal Dr
Raeford, NC 28376-2528

Mailing address

314 Teal Dr
Raeford, NC 28376-2528
Phone (910) 904-7450

Other identifiers 1

IdentifierTypeStateIssuer
89-015XVMedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031108000016 NC Part B Supplier - Clinic/Group Practice 8820909377 Receives reassigned benefits from 183 practitioners
18 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Pinehurst, NC; Troy, NC; Sanford, NC; Rockingham, NC; Fayetteville, NC; Pembroke, NC; Raeford, NC

Other NPIs on the same Medicare enrollment 15

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 15

National Provider Directory

National Provider Directory

Locations

314 Teal Dr
Raeford, NC 28376
Phone (910) 904-7450

NPI Registry JSON

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

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733270400000",
    "number": "1376513622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 TEAL DR",
            "city": "RAEFORD",
            "state": "NC",
            "postal_code": "283762528",
            "telephone_number": "910-904-7450",
            "fax_number": "910-904-7474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 TEAL DR",
            "city": "RAEFORD",
            "state": "NC",
            "postal_code": "283762528",
            "telephone_number": "910-904-7450",
            "fax_number": "910-904-7474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRSTHEALTH DENTAL CARE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-26",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A",
        "authorized_official_last_name": "FOSTER",
        "authorized_official_first_name": "MICKEY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "910-715-4473"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NC",
            "license": "H0100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89-015XV",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raeford, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.