Individual provider Active NPI

Lang Sa Thach, DMD

  • General Practice Dentistry
  • Charlotte, NC
National Provider Identifier
1396357109
Registry record updated Feb 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12560 Issued in NC
Practice address
4815 Berewick Town Center Dr Ste I&J
Charlotte, NC 28278-6733
Phone
(704) 800-0252
NPI assigned
Aug 21, 2020
Last updated
Feb 14, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN25409 FL
General Practice Dentistry 1223G0001X DGD.9717 SC
General Practice Dentistry 1223G0001X 12560 NC Primary

Addresses

Primary practice location

4815 Berewick Town Center Dr Ste I&J
Charlotte, NC 28278-6733

Mailing address

4815 Berewick Town Center Dr Unit J
Charlotte, NC 28278-6733
Phone (704) 800-0252

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DN25409FLMDGeneral Practice Dentistry
DGD.9717SCMDGeneral Practice Dentistry
12560NCMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Alterman Dhillon and Associates General Practice CurrentSince Feb 24, 2022 Accepting new patients
Alterman & Dhillon Charlotte Metro, PPLC General Practice CurrentSince Feb 24, 2022 Accepting new patients
Apex Dental PA General Practice PastSince Aug 1, 2020 Accepting new patients

Locations

4815 Berewick Town Center Dr
Ste Ij
Charlotte, NC 28278
Phone (704) 800-0252

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1597968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644796800000",
    "number": "1396357109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4815 BEREWICK TOWN CENTER DR UNIT J",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282786733",
            "telephone_number": "704-800-0252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4815 BEREWICK TOWN CENTER DR STE I&J",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282786733",
            "telephone_number": "704-800-0252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THACH",
        "first_name": "LANG",
        "middle_name": "SA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-21",
        "last_updated": "2022-02-14",
        "certification_date": "2022-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN25409",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "DGD.9717",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "12560",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Feb 14, 2022; 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.