1215257928 NPI number — DRS. BUSBY & WEBB II, P.A.

Table of content: (NPI 1215257928)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215257928 NPI number — DRS. BUSBY & WEBB II, P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DRS. BUSBY & WEBB II, P.A.
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:
BUSBY & WEBB ORTHODONTICS
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:
1215257928
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/03/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
203 MOCKSVILLE AVE
Provider Second Line Business Mailing Address:
A
Provider Business Mailing Address City Name:
SALISBURY
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28144-3359
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
704-637-9363
Provider Business Mailing Address Fax Number:
704-637-9353

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1424 FERN CREEK DR
Provider Second Line Business Practice Location Address:
C
Provider Business Practice Location Address City Name:
STATESVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28625-9376
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-414-0925
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/03/2010

Additional Information

Authorized Official

Authorized Official Last Name:
MENEES
Authorized Official First Name:
KATHERINE
Authorized Official Middle Name:
WEBB
Authorized Official Title or Position:
PRACTICE MANAGER
Authorized Official Telephone Number:
704-414-0925

Provider Taxonomy Codes

  • Taxonomy code: 1223X0400X , with the licence number:  6889 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 1223X0400X , with the licence number: 6957 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





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