Active NPI
Laetitia Ifeyinwa Sery, D.D.S.
- Pediatric Dentistry
- Gastonia, NC
National Provider Identifier
1740325232
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 8474
- Practice address
- 1367 E Garrison Blvd Ste B
Gastonia, NC 28054-5144 - Phone
- (704) 860-0945
- NPI assigned
- Feb 21, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 8474 | NC | |
| Pediatric Dentistry | 1223P0221X | 8474 | NC | Primary |
Addresses
Primary practice location
1367 E Garrison Blvd Ste B
Gastonia, NC 28054-5144
Mailing address
1367 E Garrison Blvd Ste B
Gastonia, NC 28054-5144
Phone (704) 860-0945
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8474 | Other | NC | NC STATE BOARD |
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 |
|---|---|---|---|
| 8474 | NC | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Laetitia I. Sery, DDS, PLLC | Pediatric Dentistry | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Pediatric Dentistry
- Gastonia, NC
- NPI 1679004584
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172016000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1417305600000",
"number": "1740325232",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1367 E GARRISON BLVD STE B",
"city": "GASTONIA",
"state": "NC",
"postal_code": "280545144",
"telephone_number": "704-860-0945"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1367 E GARRISON BLVD STE B",
"city": "GASTONIA",
"state": "NC",
"postal_code": "280545144",
"telephone_number": "704-860-0945"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SERY",
"first_name": "LAETITIA",
"middle_name": "IFEYINWA",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-21",
"last_updated": "2014-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NC",
"license": "8474",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "NC",
"license": "8474",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NC STATE BOARD",
"identifier": "8474",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Gastonia, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 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.