Susana C Junco, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

8465 Issued in NC

Practice address

136 Indian Trail Rd
Indian Trail, NC 28079

Phone

(704) 821-7222

Fax

(704) 821-4310

NPI assigned

Aug 27, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Richard M Holmes DMD, PA

  • General Practice Dentistry
  • Indian Trail, NC
  • NPI 1689716599
  NPD (past)

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

{
    "created_epoch": "1188172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218758400000",
    "number": "1750574331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 338",
            "city": "INDIAN TRAIL",
            "state": "NC",
            "postal_code": "28079",
            "telephone_number": "704-821-7222",
            "fax_number": "704-821-4510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 INDIAN TRAIL RD",
            "city": "INDIAN TRAIL",
            "state": "NC",
            "postal_code": "28079",
            "telephone_number": "704-821-7222",
            "fax_number": "704-821-4310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUNCO",
        "first_name": "SUSANA",
        "middle_name": "C",
        "name_prefix": "Mrs.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-27",
        "last_updated": "2008-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "8465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jaki Med Inc
• James F. Matthews OD PA
• Nancy Viola James, A-GNP
• Vanessa Starr James, LLMSW
• Jed E Levitas DMD PA
• Mildred Kaagaza, MD
• Gregory Charles Kabbes
• Kaisk Chiropractic
• Karizma Infinities Family Care Home
• Dean Katon, RPH.

• General Practice Dentistry in Indian Trail, NC
• Providers in Indian Trail, 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 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.