NPIMap

Organization Active NPI

Coastal Dentistry

  • General Practice Dentistry
  • Morehead City, NC
National Provider Identifier
1417091877
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
COASTAL DENTISTRY
Practice address
405 N 35TH St
Morehead City, NC 28557-3107
Phone
(252) 247-2169
Fax
(252) 247-9563
NPI assigned
Feb 19, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Kathleen O Cruz
Title
Office Manager
Phone
(252) 247-2169

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

405 N 35TH St
Morehead City, NC 28557-3107

Mailing address

405 N 35TH St
Morehead City, NC 28557-3107
Phone (252) 247-2169

National Provider Directory

National Provider Directory

Locations

405 N 35th St
Morehead City, NC 28557
Phone (252) 247-2169

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1417091877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 N 35TH ST",
            "city": "MOREHEAD CITY",
            "state": "NC",
            "postal_code": "285573107",
            "telephone_number": "252-247-2169",
            "fax_number": "252-247-9563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 N 35TH ST",
            "city": "MOREHEAD CITY",
            "state": "NC",
            "postal_code": "285573107",
            "telephone_number": "252-247-2169",
            "fax_number": "252-247-9563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CRUZ",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "252-247-2169"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morehead City, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.