Active NPI
Erin N Connally, DDS
- Dentist
- Charlotte, NC
National Provider Identifier
1609483312
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DE60097424
- Practice address
- 14830 Choate Cir
Charlotte, NC 28273-9105 - Phone
- (704) 588-4300
- NPI assigned
- Sep 26, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DE60097424 | WA | Primary |
Addresses
Primary practice location
14830 Choate Cir
Charlotte, NC 28273-9105
Mailing address
14830 Choate Cir
Charlotte, NC 28273-9105
Phone (704) 588-4300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DE60097424 | WA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sim USA, Incorporated | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Voluntary or Charitable Agency
- Charlotte, NC
- NPI 1376556522
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1601078400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1601078400000",
"number": "1609483312",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14830 CHOATE CIR",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282739105",
"telephone_number": "704-588-4300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14830 CHOATE CIR",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282739105",
"telephone_number": "704-588-4300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONNALLY",
"first_name": "ERIN",
"middle_name": "N",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-09-26",
"last_updated": "2020-09-26",
"certification_date": "2020-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WA",
"license": "DE60097424",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 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.