Active NPI
Tracie Vaughan, DDS
- Dentist
- Garner, NC
National Provider Identifier
1407995590
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 7719
- Practice address
- 100 Health Park Dr
Suite 105
Garner, NC 27529-6994 - Phone
- (919) 329-5556
- Fax
- (919) 329-5558
- NPI assigned
- Feb 5, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 7719 | NC | Primary |
Addresses
Primary practice location
100 Health Park Dr
Suite 105
Garner, NC 27529-6994
Mailing address
100 Health Park Dr
Suite 105
Garner, NC 27529-6994
Phone (919) 329-5556
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
| License | State | Type | Specialty |
|---|---|---|---|
| 7719 | NC | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1200528000000",
"number": "1407995590",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 HEALTH PARK DR",
"address_2": "SUITE 105",
"city": "GARNER",
"state": "NC",
"postal_code": "275296994",
"telephone_number": "919-329-5556",
"fax_number": "919-329-5558"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 HEALTH PARK DR",
"address_2": "SUITE 105",
"city": "GARNER",
"state": "NC",
"postal_code": "275296994",
"telephone_number": "919-329-5556",
"fax_number": "919-329-5558"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAUGHAN",
"first_name": "TRACIE",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-05",
"last_updated": "2008-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NC",
"license": "7719",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Garner, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.