1225579998 NPI number — AKASH M. AGHERA, DMD, PLLC

Table of content: (NPI 1225579998)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225579998 NPI number — AKASH M. AGHERA, DMD, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AKASH M. AGHERA, 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:
1225579998
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/13/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
17231 WESTMILL LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHARLOTTE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28277-3154
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
16928 LANCASTER HWY
Provider Second Line Business Practice Location Address:
UNIT 101
Provider Business Practice Location Address City Name:
CHARLOTTE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28277-2016
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
980-299-0110
Provider Business Practice Location Address Fax Number:
888-971-3858
Provider Enumeration Date:
03/15/2017

Additional Information

Authorized Official

Authorized Official Last Name:
AGHERA
Authorized Official First Name:
AKASH
Authorized Official Middle Name:
MOHANLAL
Authorized Official Title or Position:
MANAGER
Authorized Official Telephone Number:
704-421-8958

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  9213 , 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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