1245393313 NPI number — SHARON J. COBHAM, DDS, PA, V

Table of content: DR. LANCE JOSEPH LORIO D.C. (NPI 1760864672)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245393313 NPI number — SHARON J. COBHAM, DDS, PA, V

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SHARON J. COBHAM, DDS, PA, V
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:
1245393313
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/02/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2728 ANN ELIZABETH DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BURLINGTON
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27215-5111
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
336-586-1919
Provider Business Mailing Address Fax Number:
336-586-1990

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2912 MAPLEWOOD AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WINSTON SALEM
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27103-4010
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
336-765-8940
Provider Business Practice Location Address Fax Number:
336-765-7184
Provider Enumeration Date:
12/19/2006

Additional Information

Authorized Official

Authorized Official Last Name:
COBHAM
Authorized Official First Name:
SHARON
Authorized Official Middle Name:
JOVANNA
Authorized Official Title or Position:
DENTIST-OWNER
Authorized Official Telephone Number:
919-412-1033

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 5906747 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




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