1043726250 NPI number — MEGAN M. RAYNOR, DMD, PLLC

Table of content: (NPI 1043726250)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043726250 NPI number — MEGAN M. RAYNOR, DMD, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MEGAN M. RAYNOR, DMD, PLLC
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:
6
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:
1043726250
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/26/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5500 HIGHWAY 49 SOUTH
Provider Second Line Business Mailing Address:
SUITE 100
Provider Business Mailing Address City Name:
HARRISBURG
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28075
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
704-455-2177
Provider Business Mailing Address Fax Number:
704-455-3816

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5500 HIGHWAY 49 SOUTH
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
HARRISBURG
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28075
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-455-2177
Provider Business Practice Location Address Fax Number:
704-455-3816
Provider Enumeration Date:
12/26/2017

Additional Information

Authorized Official

Authorized Official Last Name:
RAYNOR
Authorized Official First Name:
MEGAN
Authorized Official Middle Name:
MORSE
Authorized Official Title or Position:
DENTIST/OWNER
Authorized Official Telephone Number:
704-516-7191

Provider Taxonomy Codes

  • Taxonomy code: 261QD0000X , with the licence number:  10376 , 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: 1699125393 . This is a "NPPES" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com