Individual provider Active NPI

Nicole R Wright, D.D.S.

  • Periodontics
  • Winston Salem, NC
National Provider Identifier
1780834457
Registry record updated May 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
8560 Issued in NC
Practice address
3809 Forrestgate Dr Ste a
Winston Salem, NC 27103-2982
Phone
(336) 768-9010
Fax
(336) 768-9011
NPI assigned
Sep 30, 2008
Last updated
May 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 9130 CO
Periodontics 1223P0300X 8560 NC Primary

Addresses

Primary practice location

3809 Forrestgate Dr Ste a
Winston Salem, NC 27103-2982

Mailing address

3809 Forrestgate Dr Ste a
Winston Salem, NC 27103-2982
Phone (336) 768-9010

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
8560NCMDMental Health Counselor
9130COMDPeriodontist

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1222732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714953600000",
    "number": "1780834457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3809 FORRESTGATE DR STE A",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271032982",
            "telephone_number": "336-768-9010",
            "fax_number": "336-768-9011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3809 FORRESTGATE DR STE A",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271032982",
            "telephone_number": "336-768-9010",
            "fax_number": "336-768-9011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRIGHT",
        "first_name": "NICOLE",
        "middle_name": "R",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-30",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CO",
            "license": "9130",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NC",
            "license": "8560",
            "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 May 6, 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.