1225331838 NPI number — GAIL M D BELVETT DDS AND ASSOCIATES PA

Table of content: (NPI 1225331838)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225331838 NPI number — GAIL M D BELVETT DDS AND ASSOCIATES PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GAIL M D BELVETT DDS AND ASSOCIATES 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:
MEBANE CHILDREN'S DENTRISTRY
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:
1225331838
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/21/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1208 RIDDLE RD
Provider Second Line Business Mailing Address:
SUITE A
Provider Business Mailing Address City Name:
DURHAM
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27713-1294
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
919-682-9707
Provider Business Mailing Address Fax Number:
919-682-0306

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1107 S FIFTH ST
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
MEBANE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27302-9597
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-682-9707
Provider Business Practice Location Address Fax Number:
919-682-0306
Provider Enumeration Date:
12/21/2010

Additional Information

Authorized Official

Authorized Official Last Name:
BELVETT
Authorized Official First Name:
GAIL
Authorized Official Middle Name:
MEREDITH DAWN
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
919-682-9707

Provider Taxonomy Codes

  • Taxonomy code: 1223P0221X , with the licence number:  7250 , 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)





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