Michael Smith Humphries, DMD
Individual provider Active NPI General Practice Dentistry · Charlotte, NC
NPI 1689244246 · NPPES record last updated Jun 28, 2021
Key facts
- NPI
- 1689244246
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 12293 (NC)
- Practice address
- 9920 Couloak Dr Ste 100
Charlotte, NC 28216-8923 - Phone
- (704) 392-7676
- NPI assigned
- Jun 28, 2021
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12293 | NC | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 12293 | NC | Yes |
Addresses
Primary practice location
9920 Couloak Dr Ste 100
Charlotte, NC 28216-8923
Mailing address
2543 Pinckney Ave
Charlotte, NC 28205-1857
Phone (704) 206-0077
Other providers in Charlotte, NC
- Terry Humphrey
- Virginia Irvin Humphreys
- Binta H Humphries Barringer
- Alana Gail Humphries
- Charles Thomas Humphries
- Nakela Humphries
- Virginia Humphries
- Zaria Davis Humphries
- Eric Bernard Hun Ter
- Amy D. Huneycutt
All providers in Charlotte, NC · General Practice Dentistry in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 28, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.