Scott M. Vines, DDS, PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6612 Issued in NC

Legal business name

SCOTT M. VINES, DDS, PLLC

Practice address

1123 S Main St
Reidsville, NC 27320-5340

Phone

(336) 342-1581

Fax

(336) 349-7350

NPI assigned

Aug 20, 2006

Last updated

Sep 17, 2008By 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

Dr. Scott Michael Vines, D.D.S.

Title

Dentist/Owner

Phone

(336) 342-1581

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221609600000",
    "number": "1477668143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1123 S MAIN ST",
            "city": "REIDSVILLE",
            "state": "NC",
            "postal_code": "273205313",
            "telephone_number": "336-342-1581",
            "fax_number": "336-349-7350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1123 S MAIN ST",
            "city": "REIDSVILLE",
            "state": "NC",
            "postal_code": "273205340",
            "telephone_number": "336-342-1581",
            "fax_number": "336-349-7350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCOTT M. VINES, DDS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2008-09-17",
        "status": "A",
        "authorized_official_last_name": "VINES",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "336-342-1581",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "6612",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "899007X",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Reidsville, NC
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• General Practice Dentistry in North Carolina

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

Verify at the official NPI Registry.