NPIMap

Organization Active NPI

East Carolina University

Doing business as East Carolina University School of Dental Medicine, Faculty Practice

  • General Practice Dentistry
  • Greenville, NC
National Provider Identifier
1790212462
Registry record updated Jul 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
EAST CAROLINA UNIVERSITY
Doing business as
East Carolina University School of Dental Medicine, Faculty Practice
Practice address
1851 Macgregor Downs Rd
Greenville, NC 27834-5925
Phone
(252) 737-7011
Fax
(252) 737-7846
NPI assigned
May 12, 2017
Last updated
Jul 26, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
EAST CAROLINA UNIVERSITYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 26, 2024

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

Authorized official

Name
Dr. Dexter Gregory Chadwick, DDS, MS
Title
Dean, School of Dental Mediicne
Phone
(252) 737-7000

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X
Endodontics 1223E0200X
General Practice Dentistry 1223G0001X Primary
Oral and Maxillofacial Pathology Dentistry 1223P0106X
Periodontics 1223P0300X
Prosthodontics 1223P0700X
Oral and Maxillofacial Surgery (Dentist) 1223S0112X
Oral and Maxillofacial Radiology Dentistry 1223X0008X
Oral Medicine Dentistry 125Q00000X

Addresses

Primary practice location

1851 Macgregor Downs Rd
Greenville, NC 27834-5925

Mailing address

1851 Macgregor Downs Rd
Greenville, NC 27834
Phone (252) 737-7122

Other names 1

  • East Carolina University School of Dental Medicine, Faculty Practice Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031106000400 NC Part B Supplier - Clinic/Group Practice 0244143246 Receives reassigned benefits from 978 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Greenville, NC; Lillington, NC; Lumberton, NC; Robersonville, NC; Spruce Pine, NC; Sylva, NC; Thomasville, NC; Washington, NC…

Other NPIs on the same Medicare enrollment 13

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 13

National Provider Directory

National Provider Directory
Tax ID family
Ecu School Medicine Cli64 organizations share this tax ID, including this one
Part of
Ecu School Medicine Cli

Organizations with this tax ID in the same state 20

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 20

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1494547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721952000000",
    "number": "1790212462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1851 MACGREGOR DOWNS RD",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "27834",
            "telephone_number": "252-737-7122",
            "fax_number": "252-737-0221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1851 MACGREGOR DOWNS RD",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278345925",
            "telephone_number": "252-737-7011",
            "fax_number": "252-737-7846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST CAROLINA UNIVERSITY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EAST CAROLINA UNIVERSITY",
        "enumeration_date": "2017-05-12",
        "last_updated": "2024-07-26",
        "certification_date": "2024-07-26",
        "status": "A",
        "authorized_official_last_name": "CHADWICK",
        "authorized_official_first_name": "DEXTER",
        "authorized_official_middle_name": "GREGORY",
        "authorized_official_title_or_position": "DEAN, SCHOOL OF DENTAL MEDIICNE",
        "authorized_official_telephone_number": "252-737-7000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223X0008X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "125Q00000X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "East Carolina University School of Dental Medicine, Faculty Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greenville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.