Axon Darren Sholar, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6268 Issued in NC

Practice address

522 S Norwood St
Wallace, NC 28466

Phone

(910) 285-7800

Fax

(910) 285-6097

NPI assigned

Jun 21, 2006

Last updated

Feb 13, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• A Darren Sholar, DDS,PA

  dba Southland Dental Care

  • General Practice Dentistry
  • Wallace, NC
  • NPI 1053561555
  Authorized official Same address or phone

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360713600000",
    "number": "1659317394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "522 S NORWOOD ST",
            "city": "WALLACE",
            "state": "NC",
            "postal_code": "28466",
            "telephone_number": "910-285-7800",
            "fax_number": "910-285-6097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "522 S NORWOOD ST",
            "city": "WALLACE",
            "state": "NC",
            "postal_code": "28466",
            "telephone_number": "910-285-7800",
            "fax_number": "910-285-6097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOLAR",
        "first_name": "AXON",
        "middle_name": "DARREN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-21",
        "last_updated": "2013-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "6268",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8997800",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "97800",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIGON",
            "identifier": "358397",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "1680308",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carrie Kyper Royer, PA-C
• Victor Jones Russell, LCAS, CSAC
• RX Medeq LLC
• Scottie Drugs of Wallace Inc (Scottie Drug Stores)
• Haley Shand
• Claudia Compton Smith, N.P.
• SSC Wallace Operating Company LLC (Brian Center Health & Rehabilitation - Wallace)
• Take Care of You Counseling Services, PLLC
• Tar Heel Human Services, Inc.
• The Lawson's House

• General Practice Dentistry in Wallace, NC
• Providers in Wallace, 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 Feb 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.