Organization Active NPI

Snow & Snow DDS PLLC

  • Dentist
  • Charlotte, NC
National Provider Identifier
1811412562
Registry record updated May 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
9178 Issued in NC
Legal business name
SNOW & SNOW DDS PLLC
Practice address
5306 South Blvd Ste a
Charlotte, NC 28217-4116
Phone
(980) 875-9158
Fax
(980) 875-9880
NPI assigned
Aug 3, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2021

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

Authorized official

Name
Ms. Karol Manchola
Title
Office Manager
Phone
(980) 875-9158

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 9178 NC Primary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 9054 NC

Addresses

Primary practice location

5306 South Blvd Ste a
Charlotte, NC 28217-4116

Mailing address

5306 South Blvd Ste a
Charlotte, NC 28217-4116
Phone (980) 226-5400

Other identifiers 2

IdentifierTypeStateIssuer
1003996919MedicaidNC
1568575330MedicaidNC

National Provider Directory

National Provider Directory

Locations

5306 South Blvd
#A
Charlotte, NC 28217
Phone (980) 226-5400

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1501718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620259200000",
    "number": "1811412562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5306 SOUTH BLVD STE A",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282174116",
            "telephone_number": "980-226-5400",
            "fax_number": "980-226-5927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5306 SOUTH BLVD STE A",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282174116",
            "telephone_number": "980-875-9158",
            "fax_number": "980-875-9880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SNOW & SNOW DDS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-03",
        "last_updated": "2021-05-06",
        "certification_date": "2021-05-06",
        "status": "A",
        "authorized_official_last_name": "MANCHOLA",
        "authorized_official_first_name": "KAROL",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "980-875-9158",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NC",
            "license": "9178",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NC",
            "license": "9054",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1003996919",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1568575330",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2021; 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.