NPIMap

Organization Active NPI

Wake Cross Roads Dentistry

  • Dental Clinic/Center
  • Raleigh, NC
National Provider Identifier
1609076074
Registry record updated May 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
7970 Issued in NC
Legal business name
WAKE CROSS ROADS DENTISTRY
Practice address
4008 Mitchell Mill Road
Suite 108
Raleigh, NC 27616
Phone
(919) 453-0777
Fax
(919) 453-0774
NPI assigned
Jul 23, 2007
Last updated
May 11, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2009

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

Authorized official

Name
Dr. David Conrad Dillard, D.D.S.NPI 1780723148
Title
President
Phone
(919) 453-0777

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 7970 NC Primary

Addresses

Primary practice location

4008 Mitchell Mill Road
Suite 108
Raleigh, NC 27616

Mailing address

4008 Mitchell Mill Road
Suite 108
Raleigh, NC 27616
Phone (919) 453-0777

Other names 1

  • David C. Dillard, D.D.S.,P.L.L.C Other name

National Provider Directory

National Provider Directory

Locations

4008 Mitchell Mill Rd
Ste 108
Raleigh, NC 27616
Phone (919) 453-0777

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": "1185148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242000000000",
    "number": "1609076074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4008 MITCHELL MILL ROAD",
            "address_2": "SUITE 108",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "27616",
            "telephone_number": "919-453-0777",
            "fax_number": "919-453-0774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4008 MITCHELL MILL ROAD",
            "address_2": "SUITE 108",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "27616",
            "telephone_number": "919-453-0777",
            "fax_number": "919-453-0774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAKE CROSS ROADS DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-23",
        "last_updated": "2009-05-11",
        "status": "A",
        "authorized_official_last_name": "DILLARD",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "CONRAD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "919-453-0777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NC",
            "license": "7970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "David C. Dillard, D.D.S.,P.L.L.C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2009; 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.