Organization Active NPI

Nelson Orthodontics

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Raleigh, NC
National Provider Identifier
1659495364
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
5991 Issued in NC
Legal business name
NELSON ORTHODONTICS
Practice address
5964 Six Forks Rd # B
Raleigh, NC 27609-3895
Phone
(919) 845-2900
Fax
(919) 845-2995
NPI assigned
Mar 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Chauncy Nelson
Title
Owner
Phone
(910) 845-3900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X 5991 NC Primary

Addresses

Primary practice location

5964 Six Forks Rd # B
Raleigh, NC 27609-3895

Mailing address

5964 Six Forks Rd # B
Raleigh, NC 27609-3895
Phone (919) 845-2900

Other identifiers 1

IdentifierTypeStateIssuer
8996428MedicaidNC

National Provider Directory

National Provider Directory

Locations

5964 Six Forks Rd
Ste B
Raleigh, NC 27609
Phone (919) 845-2900

NPI Registry JSON

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1659495364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5964 SIX FORKS RD # B",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276093895",
            "telephone_number": "919-845-2900",
            "fax_number": "919-845-2995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5964 SIX FORKS RD # B",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276093895",
            "telephone_number": "919-845-2900",
            "fax_number": "919-845-2995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NELSON ORTHODONTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "CHAUNCY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "910-845-3900",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NC",
            "license": "5991",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8996428",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.

Verify at the official NPI Registry.