Active NPI
Mark Purdy, DDS
- General Practice Dentistry
- Monroe, NC
National Provider Identifier
1710104211
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 6294
- Practice address
- 2258 W Roosevelt Blvd
Ste a
Monroe, NC 28110-3089 - Phone
- (704) 291-7100
- Fax
- (704) 291-7115
- NPI assigned
- Apr 19, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 | 6294 | NC | Primary |
Addresses
Primary practice location
2258 W Roosevelt Blvd
Ste a
Monroe, NC 28110-3089
Mailing address
399 Schad CT SW
Concord, NC 28025-1203
Phone (704) 787-2015
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 |
|---|---|---|---|
| 6294 | NC | MD | Occupational Health Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1371427200000",
"number": "1710104211",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "399 SCHAD CT SW",
"city": "CONCORD",
"state": "NC",
"postal_code": "280251203",
"telephone_number": "704-787-2015"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2258 W ROOSEVELT BLVD",
"address_2": "STE A",
"city": "MONROE",
"state": "NC",
"postal_code": "281103089",
"telephone_number": "704-291-7100",
"fax_number": "704-291-7115"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PURDY",
"first_name": "MARK",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-19",
"last_updated": "2013-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NC",
"license": "6294",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Monroe, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.