Nicholas James Penna, D.D.S.,P.A.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

NC4936 Issued in NC

Practice address

1819 Brenner Ave
Salisbury, NC 28144-2519

Phone

(704) 633-5942

Fax

(704) 639-0237

NPI assigned

Dec 19, 2006

Sex

Male

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 2

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 and National Provider Directory roles.

• Nicholas James Penna D.D.S.,P.a.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Salisbury, NC
  • NPI 1033210380
  NPD (past) Authorized official

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1689737496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1819 BRENNER AVE",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281442519",
            "telephone_number": "704-633-5942",
            "fax_number": "704-639-0237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1819 BRENNER AVE",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281442519",
            "telephone_number": "704-633-5942",
            "fax_number": "704-639-0237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNA",
        "first_name": "NICHOLAS",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "D.D.S.,P.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-19",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NC",
            "license": "NC4936",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8996806",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "899019P",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ardith Funderburk Peacock
• Peak Performance Chiropractic PLLC
• Bailey Peeler
• Madeline Marsh Pelham, PHARMD
• Patricia Ann Pelton, PSY.D.
• Penrod Medical Equipment, LLC
• David Duane Perkins, D.O.
• Marlene Perkins
• Byron Leigh Perry, MD
• Diana Leticia Petric, DO

• Orthodontics and Dentofacial Orthopedics Dentistry in Salisbury, NC
• Providers in Salisbury, NC by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.