Edward Jiachen Mao, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

13873 Issued in NC

Practice address

3020 S Miami Blvd Ste a
Durham, NC 27703-0965

Phone

(919) 598-9900

NPI assigned

Jul 2, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Lane and Associates VI DDS PA

  • General Practice Dentistry
  • Durham, NC
  • NPI 1295990406
  NPD

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

{
    "created_epoch": "1562025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721520000000",
    "number": "1952963787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 S MIAMI BLVD STE A",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277030965",
            "telephone_number": "919-598-9900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3020 S MIAMI BLVD STE A",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277030965",
            "telephone_number": "919-598-9900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14-20 MacDade Blvd Ste A",
            "address_purpose": "LOCATION",
            "city": "Collingdale",
            "state": "PA",
            "postal_code": "190231822",
            "country_code": "US",
            "telephone_number": "919-244-9155",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAO",
        "first_name": "EDWARD",
        "middle_name": "JIACHEN",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-02",
        "last_updated": "2024-07-21",
        "certification_date": "2024-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS042312",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "13873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wissam Najib Mansour, M.D.
• Maria Schmitt Mantenuto, NP
• Melissa A Manthei, COTA/L
• Sneha Mantri, MD
• Matthew Scott Manzo, PT, DPT
• David A Maple, CRNA
• Ingrid Katarina Maple, CRNA
• Maplewood Drive FCH
• Lakesha Mapp-Thompson, LCSW
• Maps Therapeutics PLLC

• General Practice Dentistry in Durham, NC
• Providers in Durham, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.