NPIMap

Organization Active NPI

Desiree T Palmer DMD PA

  • General Practice Dentistry
  • Durham, NC
National Provider Identifier
1700202066
Registry record updated Mar 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5320 Issued in NC
Legal business name
DESIREE T PALMER DMD PA
Practice address
105 Newsom St
Suite 204
Durham, NC 27704-2197
Phone
(919) 471-9106
Fax
(919) 477-0954
NPI assigned
Mar 11, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2014

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

Authorized official

Name
Tonia Lewis
Title
Practice Administrator
Phone
(919) 471-9106

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 5320 NC Primary

Addresses

Primary practice location

105 Newsom St
Suite 204
Durham, NC 27704-2197

Mailing address

105 Newsom St
Suite 204
Durham, NC 27704-2197
Phone (919) 471-9106

Other identifiers 1

IdentifierTypeStateIssuer
8996583MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Desiree T Palmer DMD PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

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": "1394496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394496000000",
    "number": "1700202066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 NEWSOM ST",
            "address_2": "SUITE 204",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277042197",
            "telephone_number": "919-471-9106",
            "fax_number": "919-477-0954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 NEWSOM ST",
            "address_2": "SUITE 204",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277042197",
            "telephone_number": "919-471-9106",
            "fax_number": "919-477-0954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESIREE T PALMER DMD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-11",
        "last_updated": "2014-03-11",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "TONIA",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "919-471-9106"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "5320",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8996583",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2014; 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.