Anthony R. Immediata, D.M.D, P.a.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

5022 Issued in NC

Legal business name

ANTHONY R. IMMEDIATA, D.M.D, P.A.

Practice address

7101 Creedmoor Rd
Suite 109
Raleigh, NC 27613-1682

Phone

(919) 846-5500

Fax

(919) 846-7964

NPI assigned

Oct 10, 2008

Last updated

Dec 3, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Barbara Sed

Title

Office Manager

Phone

(919) 846-5500

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1223596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228262400000",
    "number": "1861643678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7101 CREEDMOOR RD",
            "address_2": "SUITE 109",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276131682",
            "telephone_number": "919-846-5500",
            "fax_number": "919-846-7964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7101 CREEDMOOR RD",
            "address_2": "SUITE 109",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276131682",
            "telephone_number": "919-846-5500",
            "fax_number": "919-846-7964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANTHONY R. IMMEDIATA, D.M.D, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-10",
        "last_updated": "2008-12-03",
        "status": "A",
        "authorized_official_last_name": "SED",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "919-846-5500",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NC",
            "license": "5022",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8994426",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Kyleigh Anthony-Coats
• Sofia Cristina Anthony, DPT
• Andrew C Antill, MD
• Allison Antkowiak
• Julie Antoine

• Oral and Maxillofacial Surgery (Dentist) in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Oral and Maxillofacial Surgery (Dentist) in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 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.