Carolinas Mobile Dentistry

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

CAROLINAS MOBILE DENTISTRY

Practice address

1000 Blythe Blvd
Medical Education Building, 2ND Floor
Charlotte, NC 28203-5812

Phone

(704) 355-5317

Fax

(704) 355-0714

NPI assigned

Aug 13, 2006

Last updated

Jan 28, 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

Daniel L Wiens

Title

Senior Vice President

Phone

(704) 355-0648

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201478400000",
    "number": "1508878828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 36154",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282366154",
            "telephone_number": "704-355-5317",
            "fax_number": "704-355-0714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 BLYTHE BLVD",
            "address_2": "MEDICAL EDUCATION BUILDING, 2ND FLOOR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282035812",
            "telephone_number": "704-355-5317",
            "fax_number": "704-355-0714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINAS MOBILE DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-13",
        "last_updated": "2008-01-28",
        "status": "A",
        "authorized_official_last_name": "WIENS",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT",
        "authorized_official_telephone_number": "704-355-0648"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8902731",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carolinas Medical Center/Carolinas Healthcare System
• Carolinas Medical Equipment LLC
• Carolinas Medical Group-Psychiatric and Psychological Associates
• Carolinas Medicorp Enterprises Inc (Novant Health Urgent Care & Occupational Medicine)
• Carolinas Mental Health, PLLC
• Carolinas Nephrology and Hypertension Associates, PA
• Carolinas Pain Institute, PA (Carolinas Pain Institute)
• Carolinas Pain Institute, PA (Carolinas Pain Institute)
• Carolinas Pathology Group, PA (Carolinas Pathology Group)
• Carolinas Physician Network, Inc. (Carolinas On Site Care Employer Based Clinics)

• Dentist in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Dentist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 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.