Active NPI
Wachiraya Poonnak, DMD
- General Practice Dentistry
- Greenville, NC
National Provider Identifier
1699350223
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 12252
- Practice address
- 261 Belvoir Hwy
Greenville, NC 27834-8193 - Phone
- (252) 695-6355
- NPI assigned
- Mar 15, 2021
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 12252 | NC | Primary |
Addresses
Primary practice location
261 Belvoir Hwy
Greenville, NC 27834-8193
Mailing address
7 Professional Dr
Snow Hill, NC 28580-1332
Phone (252) 747-8162
Other practice location 1
6 Professional Dr
Snow Hill, NC 28580-1333
Phone (252) 747-3846
Other practice location 2
313 Main Street
Bayboro, NC 28515-9529
Phone (252) 745-0781
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | wpoonnak@gchcinc.org |
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 |
|---|---|---|---|
| 12252 | NC | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1615766400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1625702400000",
"number": "1699350223",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7 PROFESSIONAL DR",
"city": "SNOW HILL",
"state": "NC",
"postal_code": "285801332",
"telephone_number": "252-747-8162",
"fax_number": "252-747-8163"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "261 BELVOIR HWY",
"city": "GREENVILLE",
"state": "NC",
"postal_code": "278348193",
"telephone_number": "252-695-6355"
}
],
"practiceLocations": [
{
"address_1": "6 Professional Dr",
"address_purpose": "LOCATION",
"city": "Snow Hill",
"state": "NC",
"postal_code": "285801333",
"country_code": "US",
"telephone_number": "252-747-3846",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "313 Main Street",
"address_purpose": "LOCATION",
"city": "Bayboro",
"state": "NC",
"postal_code": "285159529",
"country_code": "US",
"telephone_number": "252-745-0781",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "POONNAK",
"first_name": "WACHIRAYA",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-03-15",
"last_updated": "2021-07-08",
"certification_date": "2021-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NC",
"license": "12252",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "wpoonnak@gchcinc.org",
"affiliation": "N",
"address_1": "6 Professional Dr",
"city": "Snow Hill",
"state": "NC",
"country_code": "US",
"postal_code": "285801333",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Greenville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.