Active NPI
Liner, Ward & Shobe DDS, PA
Doing business as Southern Dental Associates
- General Practice Dentistry
- Lexington, NC
National Provider Identifier
1578139499
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- Legal business name
- LINER, WARD & SHOBE DDS, PA
- Doing business as
- Southern Dental Associates
- Practice address
- 1370 Piedmont Dr Ste 200
Lexington, NC 27295-2053 - Phone
- (336) 249-9100
- NPI assigned
- Jun 1, 2021
- Last updated
- Feb 28, 2024
- Organization subpart
- Yes
- Parent organization
- LINER, WARD & SHOBE DDS, PA
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Dacia K Eilert-Holcomb
- Title
- Director of Operations
- Phone
- (336) 945-5555
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | Primary | ||
| Pediatric Dentistry | 1223P0221X |
Addresses
Primary practice location
1370 Piedmont Dr Ste 200
Lexington, NC 27295-2053
Mailing address
6570 Shallowford Rd
Lewisville, NC 27023-8651
Phone (336) 945-5555
Other names 1
- Southern Dental Associates
National Provider Directory
National Provider Directory- Tax ID family
- Liner Ward Shobe DDS PA
- Part of
- Liner Ward Shobe DDS PA
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1622505600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1709078400000",
"number": "1578139499",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6570 SHALLOWFORD RD",
"city": "LEWISVILLE",
"state": "NC",
"postal_code": "270238651",
"telephone_number": "336-945-5555",
"fax_number": "336-945-0125"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1370 PIEDMONT DR STE 200",
"city": "LEXINGTON",
"state": "NC",
"postal_code": "272952053",
"telephone_number": "336-249-9100"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LINER, WARD & SHOBE DDS, PA",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "LINER, WARD & SHOBE DDS, PA",
"enumeration_date": "2021-06-01",
"last_updated": "2024-02-28",
"certification_date": "2024-02-28",
"status": "A",
"authorized_official_last_name": "EILERT-HOLCOMB",
"authorized_official_first_name": "DACIA",
"authorized_official_middle_name": "K",
"authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
"authorized_official_telephone_number": "336-945-5555",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": null,
"license": null,
"primary": true
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Southern Dental Associates",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Lexington, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.