Charles Michael Guizzotti, D.D.S.

Individual provider Active NPI General Practice Dentistry · Carthage, NC

NPI 1811058563 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1811058563
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
8115 (NC)
Practice address
4824 Highway 15-501
Carthage, NC 28327-1299
Phone
(910) 947-2411
Fax
(910) 947-2719
NPI assigned
Dec 13, 2006
Sex
Male
Sole proprietor
No

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 and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20160309002098 NC Order and Referring Only - Dentist
Practitioner - Dentist
3678879186

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
8115NCMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Charles M. Guizzotti, D.D.S., P.a. General Practice Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 8115 NC Yes

Addresses

Primary practice location

4824 Highway 15-501
Carthage, NC 28327-1299

Mailing address

2107 Crigan Bluff Dr
Cary, NC 27513-8352
Phone (919) 234-3554

Other providers in Carthage, NC

All providers in Carthage, NC · General Practice Dentistry in North Carolina

Sources for this page

Verify at the official NPI Registry.