NPIMap

Organization Active NPI

K. Alex Poole II

  • General Practice Dentistry
  • Greensboro, NC
National Provider Identifier
1952497349
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6081 Issued in NC
Legal business name
K. ALEX POOLE II
Practice address
2835 Horse Pen Creek Rd
106
Greensboro, NC 27410-9700
Phone
(336) 662-0807
Fax
(336) 662-0828
NPI assigned
Oct 5, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. K. Alex Poole II, D.M.D
Title
Owner/President
Phone
(336) 662-0807

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 6081 NC Primary

Addresses

Primary practice location

2835 Horse Pen Creek Rd
106
Greensboro, NC 27410-9700

Mailing address

2835 Horse Pen Creek Rd
106
Greensboro, NC 27410-9700
Phone (336) 662-0807

Other identifiers 6

IdentifierTypeStateIssuer
810-41OtherALBCBS OF AL
V0068OtherTXBCBS OF TX
96986OtherNCBCBS OF NC
40706OtherNCBCBS OF TN
8996986MedicaidNC
864646OtherPABCBS OF PA

National Provider Directory

National Provider Directory

Locations

2835 Horse Pen Creek Rd
#106
Greensboro, NC 27410
Phone (336) 662-0807

Practitioners & affiliated clinicians

Practitioners 1

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": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1952497349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2835 HORSE PEN CREEK RD",
            "address_2": "106",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274109700",
            "telephone_number": "336-662-0807",
            "fax_number": "336-662-0828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2835 HORSE PEN CREEK RD",
            "address_2": "106",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274109700",
            "telephone_number": "336-662-0807",
            "fax_number": "336-662-0828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "K. ALEX POOLE II",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "POOLE",
        "authorized_official_first_name": "K.",
        "authorized_official_middle_name": "ALEX",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "336-662-0807",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "D.M.D"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "6081",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF AL",
            "identifier": "810-41",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TX",
            "identifier": "V0068",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC",
            "identifier": "96986",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TN",
            "identifier": "40706",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8996986",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF PA",
            "identifier": "864646",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.