Ravi Shankar Maisuria, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

14698 Issued in NC

Practice address

2831 Midway Rd SE Ste 116
Bolivia, NC 28422-8377

Phone

(910) 634-5699

NPI assigned

Jun 4, 2026

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1780531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780531200000",
    "number": "1861325490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2039 HAMBRIDGE AVE",
            "city": "KANNAPOLIS",
            "state": "NC",
            "postal_code": "280818607",
            "telephone_number": "980-333-7253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2831 MIDWAY RD SE STE 116",
            "city": "BOLIVIA",
            "state": "NC",
            "postal_code": "284228377",
            "telephone_number": "910-634-5699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAISURIA",
        "first_name": "RAVI",
        "middle_name": "SHANKAR",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-06-04",
        "last_updated": "2026-06-04",
        "certification_date": "2026-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "14698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonathan Lindau, PT, DPT
• Emily Grace Lineberger, CNM, WHNP
• Cecilia Liu, DDS
• Derek Macdonald
• Zachary Davis Maier, PA-C
• Lawrence James Mason, MD
• Journee Rebekah Matthews
• Michael Maykish, CCC-SLP
• Tracey Nicole McCarthy, DO
• Laura Ann McDaniel O'Connell, SLP

• General Practice Dentistry in Bolivia, NC
• Providers in Bolivia, 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 Jun 4, 2026; 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.