1225321995 NPI number — DR. CHRISTOPHER TAYLOR POWELL DDS

Table of content: DR. CHRISTOPHER TAYLOR POWELL DDS (NPI 1225321995)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225321995 NPI number — DR. CHRISTOPHER TAYLOR POWELL DDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
POWELL
Provider First Name:
CHRISTOPHER
Provider Middle Name:
TAYLOR
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
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:
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:
1225321995
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/27/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6301 FALLS OF NEUSE RD STE C
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RALEIGH
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27615-6866
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
919-809-8898
Provider Business Mailing Address Fax Number:
919-809-8902

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6301 FALLS OF NEUSE RD STE C
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RALEIGH
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27615-6866
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-809-8898
Provider Business Practice Location Address Fax Number:
919-809-8902
Provider Enumeration Date:
05/27/2011

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: 122300000X , with the licence number:  9132 , 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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