Active NPI
Brian P Vollmer, DMD
- General Practice Dentistry
- Mint Hill, NC
National Provider Identifier
1831750561
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 12100
- Practice address
- 5833 Phyliss LN
Mint Hill, NC 28227-9031 - Phone
- (704) 568-8010
- NPI assigned
- Jun 24, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 9384 | SC | |
| General Practice Dentistry | 1223G0001X | 12100 | NC | Primary |
Addresses
Primary practice location
5833 Phyliss LN
Mint Hill, NC 28227-9031
Mailing address
5833 Phyliss LN
Mint Hill, NC 28227-9031
Phone (704) 568-8010
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 12100 | Other | NC | NC BOARD OF DENTISTRY |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | Columbia | Other |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12100 | NC | MD | General Practice Dentistry |
| 9384 | SC | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1561334400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1627603200000",
"number": "1831750561",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5833 PHYLISS LN",
"city": "MINT HILL",
"state": "NC",
"postal_code": "282279031",
"telephone_number": "704-568-8010"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5833 PHYLISS LN",
"city": "MINT HILL",
"state": "NC",
"postal_code": "282279031",
"telephone_number": "704-568-8010"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VOLLMER",
"first_name": "BRIAN",
"middle_name": "P",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-06-24",
"last_updated": "2021-07-30",
"certification_date": "2021-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "SC",
"license": "9384",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NC",
"license": "12100",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NC BOARD OF DENTISTRY",
"identifier": "12100",
"state": "NC"
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "Columbia",
"affiliation": "N",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "Columbia",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "9 Surrey Ct",
"city": "Columbia",
"state": "SC",
"country_code": "US",
"postal_code": "292123104",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Mint Hill, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 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.