Daniel Samuel Tedder, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

104816 Issued in NC

Practice address

124 Wagner St
124 Wagner St.
Troutman, NC 28166-9627

Phone

(704) 528-9811

NPI assigned

Jun 27, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Modlin & Londry VII DDS PLLC

  • Dental Clinic/Center
  • Troutman, NC
  • NPI 1851969562
  NPD (past)

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376570929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 WAGNER ST",
            "address_2": "P.O. BOX 921",
            "city": "TROUTMAN",
            "state": "NC",
            "postal_code": "281669627",
            "telephone_number": "704-528-9811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 WAGNER ST",
            "address_2": "124 WAGNER ST.",
            "city": "TROUTMAN",
            "state": "NC",
            "postal_code": "281669627",
            "telephone_number": "704-528-9811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEDDER",
        "first_name": "DANIEL",
        "middle_name": "SAMUEL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "104816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Russell E Smith, RPH
• Robert Earl Steljes, DMD
• Robert Tennyson Stewart, DDS
• Sarah E Sturges, BHT
• Susan T. Swanson, PH.D.
• The Ultimate Home Care Solution LLC
• Therahealth Solutions LLC
• Stuart Elliott Tolman, RPH
• Lewis John Tondo, MD
• Troutman 1St RX Pharmacy

• General Practice Dentistry in Troutman, NC
• Providers in Troutman, 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 Jul 8, 2007; 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.