Individual provider Active NPI

Archana Ajith Nair, DMD

  • General Practice Dentistry
  • Fuquay Varina, NC
National Provider Identifier
1407412562
Registry record updated Nov 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
14014 Issued in NC
Practice address
1213 N Main St
Fuquay Varina, NC 27526-2616
Phone
(919) 552-9711
Fax
(919) 522-2157
NPI assigned
May 14, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 14014 NC Primary

Addresses

Primary practice location

1213 N Main St
Fuquay Varina, NC 27526-2616

Mailing address

1213 N Main St
Fuquay Varina, NC 27526-2616
Phone (919) 552-9711

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, NC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20191003001099 MA Order and Referring Only - DentistPractitioner - Dentist 7214268309
I20250117000302 NC Order and Referring Only - DentistPractitioner - Dentist 7214268309

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14014NCMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Lane and Associates I DDS PA General Practice PastSince Nov 17, 2024 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1557792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731542400000",
    "number": "1407412562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1213 N MAIN ST",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275262616",
            "telephone_number": "919-552-9711",
            "fax_number": "919-522-2157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1213 N MAIN ST",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275262616",
            "telephone_number": "919-552-9711",
            "fax_number": "919-522-2157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AJITH NAIR",
        "first_name": "ARCHANA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-14",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "14014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fuquay Varina, NC

Sources for this page

Verify at the official NPI Registry.