William Summerville DDS PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

WILLIAM SUMMERVILLE DDS PLLC

Doing business as

Distinctive Dentistry of Charlotte

Practice address

475 N Wendover Rd
Charlotte, NC 28211-1064

Phone

(704) 540-5400

Fax

(704) 364-5293

NPI assigned

Jun 2, 2006

Organization subpart

No

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

Authorized official

Name

Mary Blankenship

Title

Office Manager

Phone

(704) 540-5400

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Distinctive Dentistry of Charlotte Doing business as

Practitioners 8

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

• William Summerville, DDS

  • Dentist
  • Charlotte, NC
  • NPI 1447364674
  NPD
• Jay J Coyle

  • Dentist
  • Charlotte, NC
  • NPI 1336366541
  NPD (past)
• George Philip Haig, DDS

  • General Practice Dentistry
  • Charlotte, NC
  • NPI 1801892476
  NPD (past)
• Forrest Norman III, DDS

  • Dentist
  • Charlotte, NC
  • NPI 1649384934
  NPD (past)
• Leigh Rosner, DDS

  • Dentist
  • Charlotte, NC
  • NPI 1518181825
  NPD (past)
• Ty Louis Wooden, D.D.S.

  • Dentist
  • Reidsville, NC
  • NPI 1326329509
  NPD (past)
• Mustafa Albu-Shamah, DDS

  • Dentist
  • Rock Hill, SC
  • NPI 1184116378
  NPD (past)
• Stephen Graziani, DDS

  • Dentist
  • Charleston, WV
  • NPI 1750492633
  NPD (past)

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620691200000",
    "number": "1386681625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 N WENDOVER RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282111064",
            "telephone_number": "704-540-5400",
            "fax_number": "704-364-5293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 N WENDOVER RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282111064",
            "telephone_number": "704-540-5400",
            "fax_number": "704-364-5293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM SUMMERVILLE DDS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-02",
        "last_updated": "2021-05-11",
        "certification_date": "2021-05-11",
        "status": "A",
        "authorized_official_last_name": "BLANKENSHIP",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "704-540-5400"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5906062",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NCNCHEALTHCHOICE",
            "identifier": "018X3",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Distinctive Dentistry of Charlotte",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• William G. Ritchie D.D.S.
• William George Katibah III (Mallard Creek Family Practice)
• William H. Merlo, D.D.S. and Associates
• William Hayward King (True Care Rest Home)
• William S. Kirk Jr DDS PA
• William V Linger D D S PA
• Haseena Bacchus William, P.A.
• Williams House Human Services Coalition, Inc. (Williams House Transitional Housing Program)
• Latania Sherrell Williams McAdoo, LCMHS-S
• Winona Claire Williams Thompson, OTR/L

• General Practice Dentistry in Charlotte, NC
• Providers in Charlotte, 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 May 11, 2021; 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.