NPIMap

Organization Active NPI

Summit Avenue Cosmetic and Sedation Dental Care

  • General Practice Dentistry
  • Greensboro, NC
National Provider Identifier
1831497809
Registry record updated Apr 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6970 Issued in NC
Legal business name
SUMMIT AVENUE COSMETIC AND SEDATION DENTAL CARE
Practice address
714 Summit Ave
Greensboro, NC 27405-7832
Phone
(336) 275-5905
Fax
(336) 273-0110
NPI assigned
Mar 1, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2011

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

Authorized official

Name
Ms. Sharon Javonnah Cobham, DDS
Title
Doctor
Phone
(336) 275-5905

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 6970 NC Primary

Addresses

Primary practice location

714 Summit Ave
Greensboro, NC 27405-7832

Mailing address

714 Summit Ave
Greensboro, NC 27405-7832
Phone (336) 275-5905

National Provider Directory

National Provider Directory

Locations

714 Summit Ave
Greensboro, NC 27405
Phone (336) 275-5905

Practitioners & affiliated clinicians

Practitioners 1

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": "1298937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302480000000",
    "number": "1831497809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "714 SUMMIT AVE",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274057832",
            "telephone_number": "336-275-5905",
            "fax_number": "336-273-0110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 SUMMIT AVE",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274057832",
            "telephone_number": "336-275-5905",
            "fax_number": "336-273-0110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT AVENUE COSMETIC AND SEDATION DENTAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-01",
        "last_updated": "2011-04-11",
        "status": "A",
        "authorized_official_last_name": "COBHAM",
        "authorized_official_first_name": "SHARON",
        "authorized_official_middle_name": "JAVONNAH",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "336-275-5905",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "6970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2011; 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.