Active NPI
Maria D. Lavandero I, D.M.D.
- Pediatric Dentistry
- Winston Salem, NC
National Provider Identifier
1750495172
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 9434
- Practice address
- 2041 Silas Creek Pkwy
Winston Salem, NC 27103-5147 - Phone
- (336) 777-1272
- Fax
- (336) 777-1196
- NPI assigned
- Aug 19, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 9434 | NC | Primary |
Addresses
Primary practice location
2041 Silas Creek Pkwy
Winston Salem, NC 27103-5147
Mailing address
2041 Silas Creek Pkwy
Winston Salem, NC 27103-5147
Phone (336) 777-1272
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 |
|---|---|---|---|
| 9434 | NC | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1370563200000",
"number": "1750495172",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2041 SILAS CREEK PKWY",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271035147",
"telephone_number": "336-777-1272"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2041 SILAS CREEK PKWY",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271035147",
"telephone_number": "336-777-1272",
"fax_number": "336-777-1196"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAVANDERO",
"first_name": "MARIA",
"middle_name": "D.",
"name_prefix": "Dr.",
"name_suffix": "I",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-19",
"last_updated": "2013-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "NC",
"license": "9434",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winston Salem, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.