NPIMap

Organization Active NPI

Timothy O Imafidon Jr DDS PA

  • Dental Clinic/Center
  • Goldsboro, NC
National Provider Identifier
1720521982
Registry record updated Nov 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
10244 Issued in NC
Legal business name
TIMOTHY O IMAFIDON JR DDS PA
Doing business as
Goldsboro Pediatric Dentistry and Orthodontics
Practice address
300 S Center St
Goldsboro, NC 27530-4807
Phone
(919) 947-0800
NPI assigned
Nov 21, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2016

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

Authorized official

Name
Dr. Timothy O Imafidon Jr., DDSNPI 1437465648
Title
Owner
Phone
(919) 274-7304

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 10244 NC Primary

Addresses

Primary practice location

300 S Center St
Goldsboro, NC 27530-4807

Mailing address

300 S Center St
Goldsboro, NC 27530-4807
Phone (919) 947-0800

Other names 1

  • Goldsboro Pediatric Dentistry and Orthodontics Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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": "1479686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479686400000",
    "number": "1720521982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 S CENTER ST",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275304807",
            "telephone_number": "919-947-0800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 S CENTER ST",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275304807",
            "telephone_number": "919-947-0800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIMOTHY O IMAFIDON JR DDS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-21",
        "last_updated": "2016-11-21",
        "status": "A",
        "authorized_official_last_name": "IMAFIDON",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "919-274-7304",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NC",
            "license": "10244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Goldsboro Pediatric Dentistry and Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Goldsboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2016; 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.