Alexis Mady, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

13454 Issued in NC

Practice address

1890 Broad St
Ste 100
Fuquay Varina, NC 27526

Phone

(919) 586-8565

Fax

(919) 586-8566

NPI assigned

Jun 23, 2023

Last updated

Nov 27, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1687478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732665600000",
    "number": "1851077986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1890 BROAD ST",
            "address_2": "STE 100",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "27526",
            "telephone_number": "919-586-8565",
            "fax_number": "919-586-8566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1890 BROAD ST",
            "address_2": "STE 100",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "27526",
            "telephone_number": "919-586-8565",
            "fax_number": "919-586-8566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADY",
        "first_name": "ALEXIS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-23",
        "last_updated": "2024-11-27",
        "certification_date": "2024-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "13454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Fuquay Varina, NC
• Providers in Fuquay Varina, 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 Nov 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.