NPIMap

Organization Active NPI

Carolinas Center for Endodontics and Dental Microsurger

  • Endodontics
  • Jacksonville, NC
National Provider Identifier
1689947871
Registry record updated Dec 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
5846 Issued in NC
Legal business name
CAROLINAS CENTER FOR ENDODONTICS AND DENTAL MICROSURGER
Practice address
200 Doctors Drive
Suite G
Jacksonville, NC 28546
Phone
(910) 577-4330
Fax
(910) 577-3405
NPI assigned
Feb 17, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2022

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

Authorized official

Name
Mr. Stuart O Miller, DDSNPI 1578543898
Title
Owner
Phone
(910) 577-4330

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223E0200X 5831 NC
EndodonticsGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223E0200X 5846 NC Primary
EndodonticsGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223E0200X

Addresses

Primary practice location

200 Doctors Drive
Suite G
Jacksonville, NC 28546

Mailing address

200 Doctors Drive
Suite G
Jacksonville, NC 28546
Phone (910) 577-4330

National Provider Directory

National Provider Directory
Tax ID family
Carolinas Center for Endodontics and Dental Microsurger3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

200 Doctors Dr
Ste G
Jacksonville, NC 28546
Phone (910) 353-5234

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1329436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670371200000",
    "number": "1689947871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 DOCTORS DRIVE",
            "address_2": "SUITE G",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "28546",
            "telephone_number": "910-577-4330",
            "fax_number": "910-577-3405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 DOCTORS DRIVE",
            "address_2": "SUITE G",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "28546",
            "telephone_number": "910-577-4330",
            "fax_number": "910-577-3405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINAS CENTER FOR ENDODONTICS AND DENTAL MICROSURGER",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-17",
        "last_updated": "2022-12-07",
        "certification_date": "2022-12-07",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "STUART",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "910-577-4330",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": "NC",
            "license": "5831",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": "NC",
            "license": "5846",
            "primary": true
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2022; 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.