NPIMap

Organization Active NPI

East Carolina University

Doing business as ECU School of Dental Medicine CSLC Lillington

  • Dentist
  • Lillington, NC
National Provider Identifier
1942633482
Registry record updated Jul 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
EAST CAROLINA UNIVERSITY
Doing business as
ECU School of Dental Medicine CSLC Lillington
Practice address
80 Autumn Fern Trail
Lillington, NC 27546
Phone
(910) 814-4191
Fax
(910) 814-4198
NPI assigned
Aug 20, 2013
Last updated
Jul 26, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2024

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

Authorized official

Name
Dr. Dexter Gregory Chadwick, DDS, MS
Title
Dean, School of Dental Medicine
Phone
(252) 737-7000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

80 Autumn Fern Trail
Lillington, NC 27546

Mailing address

80 Autumn Fern Trail
Lillington, NC 27546
Phone (910) 814-4191

Other names 1

  • ECU School of Dental Medicine CSLC Lillington Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031106000400 NC Part B Supplier - Clinic/Group Practice 0244143246 Receives reassigned benefits from 978 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Greenville, NC; Lillington, NC; Lumberton, NC; Robersonville, NC; Spruce Pine, NC; Sylva, NC; Thomasville, NC; Washington, NC…

Other NPIs on the same Medicare enrollment 13

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 13

National Provider Directory

National Provider Directory
Tax ID family
Ecu Physical Medicine and Rehabilitation Center64 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 14

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 14

Practitioners & affiliated clinicians

Practitioners 6

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": "1376956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721952000000",
    "number": "1942633482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 AUTUMN FERN TRAIL",
            "city": "LILLINGTON",
            "state": "NC",
            "postal_code": "27546",
            "telephone_number": "910-814-4191",
            "fax_number": "910-814-4198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 AUTUMN FERN TRAIL",
            "city": "LILLINGTON",
            "state": "NC",
            "postal_code": "27546",
            "telephone_number": "910-814-4191",
            "fax_number": "910-814-4198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST CAROLINA UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-20",
        "last_updated": "2024-07-26",
        "certification_date": "2024-07-26",
        "status": "A",
        "authorized_official_last_name": "CHADWICK",
        "authorized_official_first_name": "DEXTER",
        "authorized_official_middle_name": "GREGORY",
        "authorized_official_title_or_position": "DEAN, SCHOOL OF DENTAL MEDICINE",
        "authorized_official_telephone_number": "252-737-7000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ECU School of Dental Medicine CSLC Lillington",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lillington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.