NPIMap

Individual provider Active NPI

Joseph Chance Powell, DDS

  • Pediatric Dentistry
  • Boone, NC
National Provider Identifier
1497019640
Registry record updated Mar 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
09693 Issued in NC
Practice address
373 Boone Heights Dr
Boone, NC 28607-4934
Phone
(828) 264-0110
NPI assigned
Jul 2, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 1086 FL
Pediatric Dentistry 1223P0221X DN014976 GA
Pediatric Dentistry 1223P0221X 09693 NC Primary

Addresses

Primary practice location

373 Boone Heights Dr
Boone, NC 28607-4934

Mailing address

373 Boone Heights Dr
Boone, NC 28607-4934
Phone (828) 291-6103

Other practice location 1

3227 N Oak Street Ext Ste A
Valdosta, GA 31605-7415
Phone (229) 247-3200

Other identifiers 2

IdentifierTypeStateIssuer
DN014976OtherGADENTAL LICENSE
09693OtherNCDENTAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1086FLMDDentist
DN014976GAMDPediatric Dentist
09693NCMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Southland Childrens Dentistry Valdosta, LLC Pediatric Dentistry Past Accepting new patients
SGPC, PC Pediatric Dentistry Past Accepting new patients
J Chance Powell DDS PA Pediatric Dentistry Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1341187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552953600000",
    "number": "1497019640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "373 BOONE HEIGHTS DR",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "286074934",
            "telephone_number": "828-291-6103",
            "fax_number": "229-241-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "373 BOONE HEIGHTS DR",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "286074934",
            "telephone_number": "828-264-0110"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3227 N Oak Street Ext Ste A",
            "address_purpose": "LOCATION",
            "city": "Valdosta",
            "state": "GA",
            "postal_code": "316057415",
            "country_code": "US",
            "telephone_number": "229-247-3200",
            "fax_number": "229-241-1900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POWELL",
        "first_name": "JOSEPH",
        "middle_name": "CHANCE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-02",
        "last_updated": "2019-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "1086",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "GA",
            "license": "DN014976",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NC",
            "license": "09693",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE",
            "identifier": "DN014976",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE",
            "identifier": "09693",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boone, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2019; 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.