Anderson and Slack and Associates

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2996 Issued in NC

Legal business name

ANDERSON AND SLACK AND ASSOCIATES

Practice address

718A West Corbett Ave
Swansboro, NC 28584

Phone

(910) 326-3611

Fax

(910) 326-1122

NPI assigned

Sep 8, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Wayne Clark Anderson

Title

DDS

Phone

(910) 326-3611

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Doris J Black, DDS

  • General Practice Dentistry
  • Swansboro, NC
  • NPI 1962512368
  NPD (past)
• Gina C Mancini, DMD

  • General Practice Dentistry
  • Swansboro, NC
  • NPI 1912017013
  NPD (past)

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

{
    "created_epoch": "1157673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1750485165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "718A WEST CORBETT AVE",
            "city": "SWANSBORO",
            "state": "NC",
            "postal_code": "28584",
            "telephone_number": "910-326-3611",
            "fax_number": "910-326-1122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "718A WEST CORBETT AVE",
            "city": "SWANSBORO",
            "state": "NC",
            "postal_code": "28584",
            "telephone_number": "910-326-3611",
            "fax_number": "910-326-1122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDERSON AND SLACK AND ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "WAYNE",
        "authorized_official_middle_name": "CLARK",
        "authorized_official_title_or_position": "DDS",
        "authorized_official_telephone_number": "910-326-3611",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "2996",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA",
            "identifier": "3224",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8990759",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "D269C",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Swansboro, NC
• Providers in Swansboro, 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 Aug 22, 2020; 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.