Lake Norman Cosmetic and Restorative Dentistry

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6624 Issued in NC

Legal business name

LAKE NORMAN COSMETIC AND RESTORATIVE DENTISTRY

Practice address

631 Brawley School Rd
Suite 500
Mooresville, NC 28117-6204

Phone

(704) 664-7774

Fax

(704) 660-0575

NPI assigned

Aug 7, 2009

Organization subpart

No

Name

Mrs. Christine Janelle Drouin

Title

Secretary of Corporation

Phone

(704) 763-7665

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

• Hoang H. Drouin, D.M.D.

  • General Practice Dentistry
  • Mooresville, NC
  • NPI 1174741003

  General Practice

  NPD (past)

Locations

• Hoang H Drouin, DMD, PA Former legal business name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 7, 2009.

{
    "created_epoch": "1249603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1249603200000",
    "number": "1760613764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "631 BRAWLEY SCHOOL RD",
            "address_2": "SUITE 500",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281176204",
            "telephone_number": "704-664-7774",
            "fax_number": "704-660-0575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 BRAWLEY SCHOOL RD",
            "address_2": "SUITE 500",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281176204",
            "telephone_number": "704-664-7774",
            "fax_number": "704-660-0575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE NORMAN COSMETIC AND RESTORATIVE DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-07",
        "last_updated": "2009-08-07",
        "status": "A",
        "authorized_official_last_name": "DROUIN",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_middle_name": "JANELLE",
        "authorized_official_title_or_position": "SECRETARY OF CORPORATION",
        "authorized_official_telephone_number": "704-763-7665",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "6624",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "899008U",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI FOR HOANG H DROUIN, DMD",
            "identifier": "1174741003",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hoang H Drouin, DMD, PA",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• All providers in Mooresville, NC
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2009; 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.