Orthodontic Care of Carolina, PA

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

3205 Issued in SC

Legal business name

ORTHODONTIC CARE OF CAROLINA, PA

Practice address

3010 Baucom Rd
Charlotte, NC 28269

Phone

(704) 509-4999

Fax

(704) 509-4961

NPI assigned

Sep 6, 2012

Organization subpart

No

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

Authorized official

Name

Mr. Ford Sawyer Cooper, DDS

Title

Owner

Phone

(704) 509-4999

Specialties & licenses 1

Addresses

Other names 1

• OrthoCare Orthodontics Doing business as

Tax ID family

Orthodontic Care of Carolina PA3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Orthodontic Care of Carolina, PA

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Columbia, SC
  • NPI 1447509492
  NPD tax ID
• Orthodontic Care of Carolina, PA

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Metairie, LA
  • NPI 1851740534
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John Scott Keadle, DDS

  • General Practice Dentistry
  • Mooresville, NC
  • NPI 1477605442
  NPD (past)

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

{
    "created_epoch": "1346889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703721600000",
    "number": "1740539782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3010 BAUCOM RD",
            "address_2": "SUITE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28269",
            "telephone_number": "704-509-4999",
            "fax_number": "704-509-4961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3010 BAUCOM RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28269",
            "telephone_number": "704-509-4999",
            "fax_number": "704-509-4961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHODONTIC CARE OF CAROLINA, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-06",
        "last_updated": "2023-12-28",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "FORD",
        "authorized_official_middle_name": "SAWYER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-509-4999",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "SC",
            "license": "3205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OrthoCare Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "OrthoCare Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Orthocarolina, PA
• Orthocarolina, PA
• Orthocarolina, PA
• Orthocarolina, PA - Bundle Payment Program Level 5
• Orthocarolina, PA - Bundle Payment Program Section 4
• Orthotic & Prosthetic Centers, Inc.
• Carylee Michelle Ortiz Valentin, LCAS-A
• Yerilis Ortiz Vazquez, CRNA
• Ana M Ortiz, CSAC
• Carlos Ortiz, CRNA

• Orthodontics and Dentofacial Orthopedics Dentistry in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2023; 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.