1184736860 NPI number — NGUYEN SILVA & SILVA DMD

Table of content: (NPI 1184736860)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184736860 NPI number — NGUYEN SILVA & SILVA DMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NGUYEN SILVA & SILVA DMD
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
CAROLINA DENTAL ASSOCIATES
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1184736860
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1505 W LEE ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GREENSBORO
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27403-2714
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
336-510-2600
Provider Business Mailing Address Fax Number:
336-510-2601

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1505 W LEE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GREENSBORO
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27403-2714
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
336-510-2600
Provider Business Practice Location Address Fax Number:
336-510-2601
Provider Enumeration Date:
08/31/2006

Additional Information

Authorized Official

Authorized Official Last Name:
NGUYEN
Authorized Official First Name:
TUNG
Authorized Official Middle Name:
THAI
Authorized Official Title or Position:
PARTNER
Authorized Official Telephone Number:
336-510-2600

Provider Taxonomy Codes

  • Taxonomy code: 261QD0000X , with the licence number:  200001336423 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 90154 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 1482957 . This is a "UNITED CONCORDIA" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 8990154 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 98714-1 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 90154 . This is a "NC STATE HEALTH CHOICE" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".




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