Organization Active NPI

Mark a. Tripp DDS., PA

  • General Practice Dentistry
  • Charlotte, NC
National Provider Identifier
1811915796
Registry record updated Jan 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7034 Issued in NC
Legal business name
MARK A. TRIPP DDS., PA
Practice address
300 Billingsley Rd Ste 202
Charlotte, NC 28211-1084
Phone
(704) 347-2557
Fax
(704) 334-2576
NPI assigned
Jul 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2012

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

Authorized official

Name
Dr. Mark A Tripp, DDS
Title
Owner
Phone
(704) 347-2557

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 7034 NC Primary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 8356 ND
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 8861 NC

Addresses

Primary practice location

300 Billingsley Rd Ste 202
Charlotte, NC 28211-1084

Mailing address

300 Billingsley Rd Ste 202
Charlotte, NC 28211-1084
Phone (704) 347-2557

National Provider Directory

National Provider Directory

Locations

300 Billingsley Rd
Ste 202
Charlotte, NC 28211
Phone (704) 347-2557

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326326400000",
    "number": "1811915796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 BILLINGSLEY RD STE 202",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282111084",
            "telephone_number": "704-347-2557",
            "fax_number": "704-334-2576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 BILLINGSLEY RD STE 202",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282111084",
            "telephone_number": "704-347-2557",
            "fax_number": "704-334-2576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK A. TRIPP DDS., PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-18",
        "last_updated": "2012-01-12",
        "status": "A",
        "authorized_official_last_name": "TRIPP",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-347-2557",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "7034",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "ND",
            "license": "8356",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "8861",
            "primary": false
        }
    ],
    "identifiers": [],
    "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 Jan 12, 2012; 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.