NPIMap

Organization Active NPI

Renee Wall, DDS, PA

  • General Practice Dentistry
  • Holly Springs, NC
National Provider Identifier
1891171138
Registry record updated Aug 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6732 Issued in NC
Legal business name
RENEE WALL, DDS, PA
Practice address
100 Hyannis Dr
Holly Springs, NC 27540-8327
Phone
(919) 362-1394
NPI assigned
Aug 10, 2015
Last updated
Aug 10, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
RENEE WALL, DDSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 10, 2015

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

Authorized official

Name
Dr. Renee A Wall, DDSNPI 1114007721
Title
Owner/Dentist
Phone
(919) 362-1394

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 9328 NC
General Practice Dentistry 1223G0001X 6732 NC Primary

Addresses

Primary practice location

100 Hyannis Dr
Holly Springs, NC 27540-8327

Mailing address

100 Hyannis Dr
Holly Springs, NC 27540-8327
Phone (919) 362-1394

Other identifiers 2

IdentifierTypeStateIssuer
811370OtherNCUNITED CONCORDIA
9008POtherNCBCBS

National Provider Directory

National Provider Directory
Part of
Renee Wall DDS PA

Locations

100 Hyannis Dr
Holly Springs, NC 27540
Phone (919) 362-1394

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1439164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439164800000",
    "number": "1891171138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HYANNIS DR",
            "city": "HOLLY SPRINGS",
            "state": "NC",
            "postal_code": "275408327",
            "telephone_number": "919-362-1394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HYANNIS DR",
            "city": "HOLLY SPRINGS",
            "state": "NC",
            "postal_code": "275408327",
            "telephone_number": "919-362-1394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEE WALL, DDS, PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RENEE WALL, DDS",
        "enumeration_date": "2015-08-10",
        "last_updated": "2015-08-10",
        "status": "A",
        "authorized_official_last_name": "WALL",
        "authorized_official_first_name": "RENEE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "919-362-1394",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "9328",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "6732",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "811370",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "9008P",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Holly Springs, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2015; 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.