1134295561 NPI number — DR. WILLIAM H SALLING JR. DDS

Table of content: DR. WILLIAM H SALLING JR. DDS (NPI 1134295561)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134295561 NPI number — DR. WILLIAM H SALLING JR. DDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SALLING
Provider First Name:
WILLIAM
Provider Middle Name:
H
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
JR.
Provider Credential Text:
DDS
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SALLING
Provider Other First Name:
BILLY
Provider Other Middle Name:
H
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
JR.
Provider Other Credential Text:
DDS
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1134295561
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/04/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2002 EASTWOOD ROAD
Provider Second Line Business Mailing Address:
STE 105
Provider Business Mailing Address City Name:
WILMINGTON
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28403
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
910-233-0374
Provider Business Mailing Address Fax Number:
910-256-2463

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2002 EASTWOOD RD
Provider Second Line Business Practice Location Address:
STE 105
Provider Business Practice Location Address City Name:
WILMINGTON
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28403
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-256-9040
Provider Business Practice Location Address Fax Number:
910-256-2463
Provider Enumeration Date:
11/28/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  3393 , 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: 27865 . This is a "UNITED CONCORDIA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 97551 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 97551 . This is a "BCBS" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".




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