Theodore Limerick, DDS, P.a.

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

THEODORE LIMERICK, DDS, P.A.

Practice address

1027 Hanes Mall Blvd
Winston Salem, NC 27103-1310

Phone

(336) 794-2813

NPI assigned

Oct 6, 2021

Organization subpart

No

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

Authorized official

Name

Theodore Limerick, DDS

Title

Owner

Phone

(336) 794-2813

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1633478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633478400000",
    "number": "1982366167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1027 HANES MALL BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271031310",
            "telephone_number": "336-794-2813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1027 HANES MALL BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271031310",
            "telephone_number": "336-794-2813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THEODORE LIMERICK, DDS, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-06",
        "last_updated": "2021-10-06",
        "certification_date": "2021-10-06",
        "status": "A",
        "authorized_official_last_name": "LIMERICK",
        "authorized_official_first_name": "THEODORE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "336-794-2813",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2021; 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.