Obi-Gwacham Roupas Sullivan Tremont PLLC-1

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

OBI-GWACHAM ROUPAS SULLIVAN TREMONT PLLC-1

Practice address

560 Woodhaven PL NW
Concord, NC 28027-5710

Phone

(704) 343-5574

NPI assigned

Nov 7, 2024

Last updated

Nov 7, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Taylor Plyler

Title

Manager

Phone

(843) 517-9960

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1730937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730937600000",
    "number": "1417770314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5833 PHYLISS LN",
            "city": "MINT HILL",
            "state": "NC",
            "postal_code": "282279031",
            "telephone_number": "843-517-9960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 WOODHAVEN PL NW",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280275710",
            "telephone_number": "704-343-5574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OBI-GWACHAM ROUPAS SULLIVAN TREMONT PLLC-1",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-07",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A",
        "authorized_official_last_name": "PLYLER",
        "authorized_official_first_name": "TAYLOR",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "843-517-9960"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Concord, NC
• Providers in Concord, 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 Nov 7, 2024; 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.