Paul D. Nifong Jr. Ddspa

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4520 Issued in NC

Legal business name

PAUL D. NIFONG JR. DDSPA

Practice address

3624 Clemmons Road
Clemmons, NC 27012-0325

Phone

(336) 766-6457

NPI assigned

Aug 10, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Paul Douglas Nifong Jr., DDSNPI 1518972934

Title

President

Phone

(336) 766-6457

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Paul Douglas Nifong Jr., D.D.S.

  • General Practice Dentistry
  • Clemmons, NC
  • NPI 1518972934
  NPD (past) Authorized official

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1437160991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 325",
            "city": "CLEMMONS",
            "state": "NC",
            "postal_code": "270120325",
            "telephone_number": "336-766-6457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3624 CLEMMONS ROAD",
            "city": "CLEMMONS",
            "state": "NC",
            "postal_code": "270120325",
            "telephone_number": "336-766-6457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL D. NIFONG JR. DDSPA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NIFONG",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "DOUGLAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "336-766-6457",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "4520",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8996451",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christian Drew Parkinson, DO
• Sarah G Parunak, PHARMD
• Mark Albert Pashayan, MD
• Nehali S Patel
• Pathways to Peace Counseling, PLLC
• Paul W Williams (Williams Chiropractic)
• Audra Pavlansky, LMFT
• Mariel Pfiffner, MA
• Alma L Pfirman
• Austin Taylor Phillips, PHARM.D., R.PH.

• General Practice Dentistry in Clemmons, NC
• Providers in Clemmons, 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 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.