1083719546 NPI number — TREMAN AND TREMAN DDS PA

Table of content: (NPI 1417293721)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083719546 NPI number — TREMAN AND TREMAN DDS PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TREMAN AND TREMAN DDS PA
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:
Provider Other Organization Name Type Code:
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:
1083719546
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:
1801 S 16TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WILMINGTON
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28401-6608
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
910-762-4867
Provider Business Mailing Address Fax Number:
910-763-5622

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1801 S 16TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WILMINGTON
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28401-6608
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-762-4867
Provider Business Practice Location Address Fax Number:
910-763-5622
Provider Enumeration Date:
09/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
TREMAN
Authorized Official First Name:
STEVEN
Authorized Official Middle Name:
JOSEPH
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
910-762-4867

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  1109 , 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: 420609 . This is a "UNITED CONCORDIA STEVEN" identifier . This identifiers is of the category "OTHER".
  • Identifier: $$$$$$$$$ . This is a "STEVEN TREMAN SSN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 98534 . This is a "BCBS # MICHAEL TREMAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 420609 . This is a "UNITED CONCORIDA MICHAEL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7998521 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 98521 . This is a "BCBS NUMBER DR. STEVE" identifier . This identifiers is of the category "OTHER".
  • Identifier: $$$$$$$$$ . This is a "MICHAEL TREMAN SSN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 8998534 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




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