Daria Clegg Diaby, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

10704 Issued in NC

Practice address

10018 Benfield Rd Ste 204
Charlotte, NC 28269-8819

Phone

(704) 228-0311

NPI assigned

Jun 29, 2017

Last updated

Dec 30, 2019By 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

Other names 1

• Daria Parice Clegg Former name

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": "1498694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577664000000",
    "number": "1881115772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 BLOOMOVER ST",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280259055",
            "telephone_number": "704-615-9922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10018 BENFIELD RD STE 204",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282698819",
            "telephone_number": "704-228-0311"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2225 E W T Harris Blvd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282135384",
            "country_code": "US",
            "telephone_number": "704-494-4050",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1851 MacGregor Downs Rd",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "NC",
            "postal_code": "278345925",
            "country_code": "US",
            "telephone_number": "252-737-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIABY",
        "first_name": "DARIA",
        "middle_name": "CLEGG",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-29",
        "last_updated": "2019-12-30",
        "certification_date": "2019-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "10704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DARIA",
            "last_name": "CLEGG",
            "middle_name": "PARICE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Dentist in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Dentist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2019; 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.