Individual provider Active NPI

Mauro Forgearini Nunes, DDS

  • General Practice Dentistry
  • Durham, NC
National Provider Identifier
1770065435
Registry record updated Sep 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12475 Issued in NC
Practice address
3400 Croasdaile Dr Ste 209
Durham, NC 27705-6815
Phone
(919) 383-7020
NPI assigned
Aug 29, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 0199 NC
General Practice Dentistry 1223G0001X 12475 NC Primary

Addresses

Primary practice location

3400 Croasdaile Dr Ste 209
Durham, NC 27705-6815

Mailing address

3400 Croasdaile Dr Ste 209
Durham, NC 27705-6815
Phone (919) 383-7020

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

LicenseStateTypeSpecialty
0199NCMDGeneral Practice Dentistry
12475NCMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Mauro Nunes, DDS Ms, PLLC General Practice CurrentSince Sep 15, 2024 Accepting new patients
Laura a Parra, DDS, PA PastSince Sep 15, 2024 Accepting new patients

Locations

3400 Croasdaile Dr
Ste 209
Durham, NC 27705
Phone (919) 383-7020

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1535500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726012800000",
    "number": "1770065435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 CROASDAILE DR STE 209",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277056815",
            "telephone_number": "919-383-7020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 CROASDAILE DR STE 209",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277056815",
            "telephone_number": "919-383-7020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUNES",
        "first_name": "MAURO",
        "middle_name": "FORGEARINI",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-29",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "0199",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "12475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2024; 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.