Brookdale Dental Care

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7388 Issued in NC

Legal business name

BROOKDALE DENTAL CARE

Practice address

9621 Brookdale Dr Ste 200
Charlotte, NC 28215-8786

Phone

(704) 597-7772

Fax

(704) 597-7078

NPI assigned

Jun 7, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Kong Vang, DMD

Title

Dentist

Phone

(704) 597-7772

Specialties & licenses 1

Addresses

Other names 1

• Kong Vang DMD,PA Other name

Locations

Practitioners 1

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

• Aixa Yari Devarie Morales, DMD

  • Dentist
  • Hillsboro, OR
  • NPI 1689915084
  NPD (past)

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

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207699200000",
    "number": "1831392844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9621 BROOKDALE DR STE 200",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282158786",
            "telephone_number": "704-597-7772",
            "fax_number": "704-597-7078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9621 BROOKDALE DR STE 200",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282158786",
            "telephone_number": "704-597-7772",
            "fax_number": "704-597-7078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKDALE DENTAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-07",
        "last_updated": "2008-04-09",
        "status": "A",
        "authorized_official_last_name": "VANG",
        "authorized_official_first_name": "KONG",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "704-597-7772",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "7388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kong Vang DMD,PA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Caleb Bromley
• Scott G Brone, PT
• Christina Bronte Ferri, LCSW
• Abigail Brook
• Sage E Brook, CNM
• Brookdale Place of South Charlotte, LLC
• Melissa Virginia Brooker
• Alex J Brooket, DPT
• Leanna Brooks Evariste, MD
• Latifa Jamila Brooks-Clark, LCSWA

• General Practice Dentistry in Charlotte, NC
• Providers in Charlotte, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2008; 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.