NPIMap

Organization Active NPI

Raymond Garrison DDS PA -Uda

Doing business as South Park

  • General Practice Dentistry
  • Charlotte, NC
National Provider Identifier
1437280013
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3549 Issued in NC
Legal business name
RAYMOND GARRISON DDS PA -UDA
Doing business as
South Park
Practice address
2901 Coltsgate Rd
Suite 201
Charlotte, NC 28211-3571
Phone
(704) 362-1211
Fax
(704) 362-4321
NPI assigned
Mar 8, 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
Raymond Garrison
Title
President
Phone
(704) 549-1509

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 3549 NC Primary

Addresses

Primary practice location

2901 Coltsgate Rd
Suite 201
Charlotte, NC 28211-3571

Mailing address

2901 Coltsgate Rd
Suite 201
Charlotte, NC 28211-3571
Phone (704) 362-1211

Other names 1

  • South Park Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Raymond Garrison DDS PA13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1437280013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 COLTSGATE RD",
            "address_2": "SUITE 201",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282113571",
            "telephone_number": "704-362-1211",
            "fax_number": "704-362-4321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 COLTSGATE RD",
            "address_2": "SUITE 201",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282113571",
            "telephone_number": "704-362-1211",
            "fax_number": "704-362-4321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAYMOND GARRISON DDS PA -UDA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GARRISON",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "704-549-1509"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "3549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Park",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charlotte, 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.