Edward George Geisel, DDS
Individual provider Active NPI General Practice Dentistry · East Bend, NC
NPI 1730280488 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1730280488
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- NC5590 (NC)
- Practice address
- 201 Neill LN
East Bend, NC 27018 - Phone
- (336) 699-8001
- Fax
- (336) 699-5030
- NPI assigned
- Sep 26, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160621000321 | NC | Order and Referring Only - Dentist |
3476844549 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5590 | NC | MD | Professional Counselor |
| NC5590 | NC | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Edward G Geisel DDS PLLC | General Practice | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | NC5590 | NC | Yes |
Addresses
Primary practice location
201 Neill LN
East Bend, NC 27018
Mailing address
PO Box 130
201 Neill Lane
East Bend, NC 27018
Phone (336) 699-4327
Other providers in East Bend, NC
- Edith M. Chance
- Edward G Geisel DDS PLLC
- Eos Pelvic Health and Wellness LLC
- Gaston Family Health Services Inc
- Gaston Family Health Services, Inc.
- Sherye Moore Hall
- Crystal D Helmeid
- Katrina Johnson
- Lindsee Mae Kyles
- Jeda Charlise Lee
All providers in East Bend, NC · General Practice Dentistry in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.