Active NPI
Laurie Tedder Campbell, DMD
- Pediatric Dentistry
- Charlotte, NC
National Provider Identifier
1689808164
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 10159
- Practice address
- 7820 Ballantyne Commons Pkwy Ste 200
Charlotte, NC 28277-2889 - Phone
- (704) 759-0000
- Fax
- (704) 759-9937
- NPI assigned
- May 12, 2009
- Last updated
- Oct 5, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 10159 | NC | Primary |
Addresses
Primary practice location
7820 Ballantyne Commons Pkwy Ste 200
Charlotte, NC 28277-2889
Mailing address
7820 Ballantyne Commons Pkwy Ste 200
Charlotte, NC 28277-2889
Phone (704) 759-0000
Other names 1
- Dr. Laurie Michelle Tedder
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10159 | NC | MD | Pediatric Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Long ,Laxer & Savage DDS, PLLC | Pediatric Dentistry | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Pediatric Dentistry
- Charlotte, NC
- NPI 1558360974
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1242086400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1444003200000",
"number": "1689808164",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7820 BALLANTYNE COMMONS PKWY STE 200",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282772889",
"telephone_number": "704-759-0000",
"fax_number": "704-759-9937"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7820 BALLANTYNE COMMONS PKWY STE 200",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282772889",
"telephone_number": "704-759-0000",
"fax_number": "704-759-9937"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMPBELL",
"first_name": "LAURIE",
"middle_name": "TEDDER",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-05-12",
"last_updated": "2015-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "NC",
"license": "10159",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "LAURIE",
"last_name": "TEDDER",
"middle_name": "MICHELLE",
"prefix": "DR.",
"credential": "DMD",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.