Individual provider Active NPI

Daniel Amyradakis, D.D.S

  • General Practice Dentistry
  • Fuquay Varina, NC
National Provider Identifier
1902247976
Registry record updated Jul 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
11339 Issued in NC
Practice address
280 Bramblehill Dr
Fuquay Varina, NC 27526-2377
Phone
(919) 552-1044
NPI assigned
Jul 8, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 11339 NC Primary

Addresses

Primary practice location

280 Bramblehill Dr
Fuquay Varina, NC 27526-2377

Mailing address

280 Bramblehill Dr
Fuquay Varina, NC 27526-2377
Phone (919) 552-1044

Other practice location 1

315 E Chatham St Ste 100
Cary, NC 27511-3472
Phone (919) 462-9338

Other practice location 2

1310 5th Ave # 100
Garner, NC 27529-3638
Phone (919) 838-7388

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jul 12, 2022 through Jul 12, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
11339NCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Amyradakis Mann and Associates, DDS PA CurrentSince Jul 12, 2020 Accepting new patients
C. Ashley Mann, DDS General Practice Past Accepting new patients
Charles Ashley Mann DDS PA 2 Past Accepting new patients
James S McKenzie DDS PA PastSince Jul 12, 2020 Accepting new patients

Locations

280 Bramblehill Dr
Fuquay Varina, NC 27526
Phone (919) 552-1044

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1373241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594339200000",
    "number": "1902247976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 BRAMBLEHILL DR",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275262377",
            "telephone_number": "919-552-1044",
            "fax_number": "239-303-2415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 BRAMBLEHILL DR",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275262377",
            "telephone_number": "919-552-1044"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "315 E Chatham St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Cary",
            "state": "NC",
            "postal_code": "275113472",
            "country_code": "US",
            "telephone_number": "919-462-9338",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1310 5th Ave # 100",
            "address_purpose": "LOCATION",
            "city": "Garner",
            "state": "NC",
            "postal_code": "275293638",
            "country_code": "US",
            "telephone_number": "919-838-7388",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AMYRADAKIS",
        "first_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-07-08",
        "last_updated": "2020-07-10",
        "certification_date": "2020-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "11339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fuquay Varina, NC

Sources for this page

Verify at the official NPI Registry.