Victor Ivan Perry, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12433 Issued in NC

Practice address

6316 E Independence Blvd
Charlotte, NC 28212-6953

Phone

(980) 265-3180

NPI assigned

Apr 22, 2021

Last updated

Sep 10, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Charlotte Community Health Clinic, Inc.

  • Federally Qualified Health Center (FQHC)
  • Charlotte, NC
  • NPI 1528363868
  Medicare reassignment NPD
• Charlotte Community Health Clinic, Inc.

  • Federally Qualified Health Center (FQHC)
  • Charlotte, NC
  • NPI 1073367249
  NPD
• Charlotte Community Health Clinic, Inc.

  dba Charlotte Community Health Clinic Family Dentistry

  • Federally Qualified Health Center (FQHC)
  • Charlotte, NC
  • NPI 1215499520
  NPD
• Riccobene & Associates I, DDS, P.a.

  dba Riccobene Associates Family Dentistry - Independence

  • General Practice Dentistry
  • Charlotte, NC
  • NPI 1538978531
  NPD

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

{
    "created_epoch": "1619049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631232000000",
    "number": "1720660483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6316 E INDEPENDENCE BLVD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282126953",
            "telephone_number": "980-265-3180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6316 E INDEPENDENCE BLVD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282126953",
            "telephone_number": "980-265-3180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY",
        "first_name": "VICTOR",
        "middle_name": "IVAN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-22",
        "last_updated": "2021-09-10",
        "certification_date": "2021-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "12433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacey Renea Perry
• Steven Michael Perry, MD
• Teasha Perry
• Tinijal Perry
• Vanessa Marie Perry, RN, PNP
• Kelly Lynne Perryman, MD
• Kathleen Wunder Persavich, MD
• Jenna Frances Persky, APRN
• Person Centered Partnerships Inc (Amara Wellness)
• Person Centered Partnerships, Inc.

• General Practice Dentistry in Charlotte, NC
• Providers in Charlotte, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.