Coleman and Dastrup PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

COLEMAN AND DASTRUP PLLC

Practice address

460 S Main St Ste 101
Davidson, NC 28036-8006

Phone

(704) 896-5850

NPI assigned

Oct 19, 2021

Last updated

Oct 19, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Andrea Leight St-Cyr

Title

Patient Coordinator

Phone

(704) 896-5850

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1634601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634601600000",
    "number": "1649933490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4297",
            "city": "DAVIDSON",
            "state": "NC",
            "postal_code": "280364297",
            "telephone_number": "704-896-5850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 S MAIN ST STE 101",
            "city": "DAVIDSON",
            "state": "NC",
            "postal_code": "280368006",
            "telephone_number": "704-896-5850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLEMAN AND DASTRUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-19",
        "last_updated": "2021-10-19",
        "certification_date": "2021-09-28",
        "status": "A",
        "authorized_official_last_name": "ST-CYR",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_middle_name": "LEIGHT",
        "authorized_official_title_or_position": "PATIENT COORDINATOR",
        "authorized_official_telephone_number": "704-896-5850",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yongyue Chen, MD
• Joseph Nnamdi Chukwu Jr., PHARMD
• Clark Counseling, PLLC
• Erin M Clark, MSW
• Kelley Cock, LPCA
• Dennis J. Coleman, D.D.S.
• Herbert Neal Collins Jr., M.D.
• Tanya Leal Condiano, PA-C
• Allison Jane Copeck, LCSW
• Ryan Austin Corbello, MD

• General Practice Dentistry in Davidson, NC
• Providers in Davidson, 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 Oct 19, 2021; 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.