Amanda Dixon Cerqueira, DDS, PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7597 Issued in NC

Practice address

1328 N. Lake Blvd
Suite 107
Carolina Beach, NC 28428

Phone

(910) 458-3232

Fax

(910) 458-3241

NPI assigned

Oct 3, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Amanda Cerqueira, DDS, PA

  • General Practice Dentistry
  • Carolina Beach, NC
  • NPI 1922284470
  NPD (past)

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649365099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1328 N. LAKE BLVD",
            "address_2": "SUITE 107",
            "city": "CAROLINA BEACH",
            "state": "NC",
            "postal_code": "28428",
            "telephone_number": "910-458-3232",
            "fax_number": "910-458-3241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1328 N. LAKE BLVD",
            "address_2": "SUITE 107",
            "city": "CAROLINA BEACH",
            "state": "NC",
            "postal_code": "28428",
            "telephone_number": "910-458-3232",
            "fax_number": "910-458-3241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CERQUEIRA",
        "first_name": "AMANDA",
        "middle_name": "DIXON",
        "name_prefix": "Mrs.",
        "credential": "DDS, PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "7597",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5902229",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John B Callahan, BSW, MPA, CCM
• Carolina Beach Counseling, LLC
• Carolina Beach Physical Therapy
• Kaitlyn Leeann Carpenter, PT, DPT
• Allison Carte
• Roberta Clark
• Coastal Mental Health Service Providers
• Corey Andolfi, Ma, LMFT, Nbcch, PLLC
• Cornerstone Care Coordination, LLC
• Donald Russel Crawford IV

• General Practice Dentistry in Carolina Beach, NC
• Providers in Carolina Beach, 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 Jul 8, 2007; 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.