NPIMap

Organization Active NPI

Larry Dashow MD PC

Doing business as Pender Surgical Service

  • Specialist
  • Burgaw, NC
National Provider Identifier
1528247137
Registry record updated Aug 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
200300461 Issued in NC
Legal business name
LARRY DASHOW MD PC
Doing business as
Pender Surgical Service
Practice address
308 S Bennett St
Burgaw, NC 28425-5048
Phone
(910) 259-8001
Fax
(910) 259-8003
NPI assigned
Oct 31, 2007
Last updated
Aug 4, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2010

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

Authorized official

Name
Dr. Larry J Dashow, MDNPI 1326001447
Title
President
Phone
(910) 259-8001

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 200300461 NC Primary

Addresses

Primary practice location

308 S Bennett St
Burgaw, NC 28425-5048

Mailing address

308 S Bennett St
Burgaw, NC 28425-5048
Phone (910) 259-8001

Other identifiers 2

IdentifierTypeStateIssuer
13350OtherNCBCBS
8913350MedicaidNC

Other names 1

  • PENDER SURGICAL SERVICE Doing business as

National Provider Directory

National Provider Directory

Locations

308 S Bennett St
Burgaw, NC 28425
Phone (910) 259-8001

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1193788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280880000000",
    "number": "1528247137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 S BENNETT ST",
            "city": "BURGAW",
            "state": "NC",
            "postal_code": "284255048",
            "telephone_number": "910-259-8001",
            "fax_number": "910-259-8003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 S BENNETT ST",
            "city": "BURGAW",
            "state": "NC",
            "postal_code": "284255048",
            "telephone_number": "910-259-8001",
            "fax_number": "910-259-8003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LARRY DASHOW MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-31",
        "last_updated": "2010-08-04",
        "status": "A",
        "authorized_official_last_name": "DASHOW",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "910-259-8001",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NC",
            "license": "200300461",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "13350",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8913350",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PENDER SURGICAL SERVICE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Burgaw, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2010; 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.