C. Lee Bass, III, DDS, PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6420 Issued in NC

Legal business name

C. LEE BASS, III, DDS, PA

Practice address

646 Signal Hill Drive Ext
Statesville, NC 28625-4353

Phone

(704) 873-3321

NPI assigned

Sep 6, 2006

Last updated

Aug 22, 2020By 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. Carl Lee Bass III, DDSNPI 1275556060

Title

President/Dentist

Phone

(704) 873-3321

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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.

• Carl Lee Bass III, D.D.S.

  • General Practice Dentistry
  • Statesville, NC
  • NPI 1275556060
  NPD (past) Authorized official

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1568565711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "646 SIGNAL HILL DRIVE EXT",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286254353",
            "telephone_number": "704-873-3321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "646 SIGNAL HILL DRIVE EXT",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286254353",
            "telephone_number": "704-873-3321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "C. LEE BASS, III, DDS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BASS",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PRESIDENT/DENTIST",
        "authorized_official_telephone_number": "704-873-3321",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "6420",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNC",
            "identifier": "90511",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "467563",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Jonathan Butlak, CRNA
• David Richard Butler, RPH
• Ellis Ray Butler II, LCAS-A
• Ronald Butler, R.N.
• Kelsey Butz, AU.D
• Joreca Alexandria Caldwell
• Lisa Diana Cale
• Jill Suzanne Calhoun, PA-C
• Jessica Raven Callaghan, PHARMD
• Marie Camp, QP

• General Practice Dentistry in Statesville, NC
• Providers in Statesville, NC by specialty
• General Practice Dentistry in North Carolina

• 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.