Mazda Berenjian DDS PA

Primary specialty

DentistTaxonomy code 122300000X

License

8751 Issued in NC

Legal business name

MAZDA BERENJIAN DDS PA

Practice address

560 Dabney Drive
Suite C
Henderson, NC 27536

Phone

(252) 492-6004

Fax

(252) 492-0994

NPI assigned

May 29, 2007

Organization subpart

No

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

Authorized official

Name

Jamie M. Brummitt

Title

Office Manager

Phone

(252) 492-6004

Specialties & licenses 1

Addresses

Other names 1

• Henderson Family Dentistry Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mazda Berenjian, D.D.S.

  • Dentist
  • Henderson, NC
  • NPI 1275777245
  NPD (past)
• Mark Vedder Wainright, D.D.S., M.S.

  • Dentist
  • Henderson, NC
  • NPI 1245261080
  NPD (past)

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471219200000",
    "number": "1639370778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 DABNEY DRIVE",
            "address_2": "SUITE C",
            "city": "HENDERSON",
            "state": "NC",
            "postal_code": "27536",
            "telephone_number": "252-492-6004",
            "fax_number": "252-492-0994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 DABNEY DRIVE",
            "address_2": "SUITE C",
            "city": "HENDERSON",
            "state": "NC",
            "postal_code": "27536",
            "telephone_number": "252-492-6004",
            "fax_number": "252-492-0994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAZDA BERENJIAN DDS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-29",
        "last_updated": "2016-08-15",
        "status": "A",
        "authorized_official_last_name": "BRUMMITT",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "252-492-6004"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NC",
            "license": "8751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Henderson Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Evangeline D. Matthews, LCSWA, LCASA
• Joseph Alan Mauzy
• Maxim Habilitation Services, LLC
• Maxim Healthcare Services, Inc.
• Tami B May, CRNA
• Samuel G McCaskill Jr., MD
• Victoria McCloskey, OTR/L
• Shumaine McCloud
• Kimberly McCowan, LPCA
• Hope McCoy, LPC

• Dentist in Henderson, NC
• Providers in Henderson, NC by specialty
• Dentist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2016; 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.