DR. JOHN E FIDLER JR. (NPI# 1003867524) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003867524 |
| Entity Type | Individual |
| Full Name | DR. JOHN E FIDLER JR. |
| Credential | D.D.S. |
| Practice Address |
2400 Wayne Memorial Dr Suite K Goldsboro NC 27534-1789 |
| Practice Telephone | 9197362082 |
| Practice Fax Number | 9197340893 |
| Mailing Telephone | 9197362082 |
| Mailing Fax Number | 9197340893 |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
7575 | NC | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | BCBS OF NC | 902J5 | 01 |
| NC | 89902J5 | 05 | |
| NC | UNITED CONCORDIA | 0160988 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750501722 | John Perry Fidler | Chiropractor | 2301 Us Hwy 105 S, Boone, NC 28679 | 2007-05-01 |
| 1164542437 | John Martin Fidler | Prosthetic/Orthotic Supplier | 26 Baltimore St, Gettysburg, PA 17325 | 2007-03-30 |
| 1851903256 | John H Fidler IIi | Physical Therapist | 633 Middlesex Tpke, Old Saybrook, CT 06475-1220 | 2020-08-18 |
| Street Address |
2400 WAYNE MEMORIAL DR SUITE K |
| City | GOLDSBORO |
| State | NC |
| Zip Code | 27534-1789 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922000678 | Benjamin D Eskra | Plastic Surgery | 2400 Wayne Memorial Dr, Suite B, Goldsboro, NC 27534-1789 | 2005-08-12 |
| 1477912632 | Jamie Ryan Ham | Nurse Practitioner | 2400 Wayne Memorial Dr, Suite I, Goldsboro, NC 27534-1789 | 2016-02-16 |
| 1932565694 | Swack Medical Associates | Internal Medicine | 2400 Wayne Memorial Dr, Suite C, Goldsboro, NC 27534-1789 | 2016-01-12 |
| 1851627780 | Goldsboro Medical Clinic | Non-Pharmacy Dispensing Site | 2400 Wayne Memorial Dr, Suite 1, Goldsboro, NC 27534-1789 | 2009-10-28 |
| 1396978169 | Wayne Health Physicians | Clinic/Center | 2400 Wayne Memorial Dr, Suite J, Goldsboro, NC 27534-1789 | 2009-08-27 |
| 1548409261 | Waynesborough Psychological Services | Psychologist | 2400 Wayne Memorial Dr, Suite E, Goldsboro, NC 27534-1789 | 2009-02-19 |
| 1598943813 | Goldsboro Medical Center, P.a. | Specialist | 2400 Wayne Memorial Dr, Suite J, Goldsboro, NC 27534-1789 | 2008-02-08 |
| 1891854311 | Paula Hill Ivey | Nurse Practitioner | 2400 Wayne Memorial Dr, Suite A, Goldsboro, NC 27534-1789 | 2006-12-08 |
| 1780763003 | Christopher D. Boyle | Psychologist | 2400 Wayne Memorial Dr, Suite E, Goldsboro, NC 27534-1789 | 2006-11-06 |
| 1285725697 | Christine Kabanga Ilunga | Internal Medicine | 2400 Wayne Memorial Dr, Suite D, Goldsboro, NC 27534-1789 | 2006-09-28 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457875767 | Trent Jonathan Forshey | Physical Therapist | 2126 Wayne Memorial Dr, Goldsboro, NC 27534 | 2017-07-28 |
| 1336685551 | Wayne Al Holdings, LLC | Assisted Living Facility | 901 West New Hope Rd, Goldsboro, NC 27534 | 2017-01-11 |
| 1952845471 | Latoya Faulk | Social Worker | 121 Carolina Forest Drive, Goldsboro, NC 27534 | 2016-12-19 |
| 1528415841 | Kelby Joseph Sage Durnin | Military Health Care Provider | 1020 Jabara Avenue, Seymour Johnson Afb, NC 27534 | 2016-05-17 |
| 1528490604 | Eric Christian Bourgeois | Physical Therapist | 1101a Gracie Pl, Goldsboro, NC 27534 | 2013-07-31 |
| 1831439165 | Erica Nicole Davis | Optometrist | 20/20 Vision Center 625 North Berkeley Blvd, Suite D, Goldsboro, NC 27534 | 2013-02-23 |
| 1891039236 | Betty Webb Zimmerman | Nurse Practitioner | 204 Cox Blvd, Goldsboro, NC 27534 | 2012-11-26 |
| 1144595265 | Life Recovery Psychological Services | Counselor | 1202-c Wayne Memorial Dr, Goldsboro, NC 27534 | 2012-03-22 |
| 1558596536 | Taylor Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 802 Taylor St, Goldsboro, NC 27534 | 2009-05-20 |
| 1780895136 | Sherrie Fennell Edwards | Dietitian, Registered | 1500 Lanely Ave., Seymour Johnson Afb, Golsboro, NC 27534 | 2007-05-25 |
| Find all providers in zip 27534 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023075942 | Richard D Kruer Jr. | Dentist | 2300 Wayne Memorial Dr Ste G, Goldsboro, NC 27534-1747 | 2006-04-26 |
| 1376963439 | Uday N Reebye, Md, Dmd, Pa | Dentist | 2300 Wayne Memorial Dr, Suite G, Goldsboro, NC 27534 | 2014-04-16 |
| 1780831487 | Matthew B Richman | Dentist | 2300 Wayne Memorial Dr, Goldsboro, NC 27534-1726 | 2008-08-25 |
| 1699725176 | Frederick L Nance IIi | Dentist | 2400 Wayne Memorial Dr, Suite K, Goldsboro, NC 27534-1789 | 2006-05-12 |
| 1518917657 | Gregory J Lutcavage | Dentist | 2400 Wayne Memorial Dr, Suite K, Goldsboro, NC 27534-1789 | 2006-05-11 |
| 1992754311 | Meadows Lutcavage Smith Vinton Fidler & Long Dds Pa | Dentist | 2400 Wayne Memorial Dr, Suite K, Goldsboro, NC 27534-1789 | 2006-05-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689224495 | Graham H. Wilson, Dds, Pa | Dentist | 7971 Market Street, Wilmington, NC 28411-9383 | 2019-09-13 |
| 1699263137 | John Breeze | Dentist | Duke University Medical Centre, Durham, NC 27710-0001 | 2018-04-30 |
| 1750823746 | Nazir Ahmad Dds V Pa | Dentist | 2500 Blue Ridge Rd Ste 201, Raleigh, NC 27607-7515 | 2016-11-08 |
| 1447600119 | Jason Michael Goldberg | Dentist | 8815 Christenbury Pkwy Ste 40, Concord, NC 28027-0261 | 2016-06-14 |
| 1760839757 | Nazir Ahmad Dds Iv, Pa | Dentist | 3150 Rogers Rd Ste 111, Wake Forest, NC 27587-4196 | 2016-05-19 |
| 1801262530 | Bradley Paul Storrs | Dentist | 6837 Normandy Rd Bldg B, Attn: Charles Bernatovitz, Fort Bragg, NC 28310-0001 | 2015-08-17 |
| 1003296831 | Jesse Eric Ricciuti | Dentist | 10042 Park Cedar Dr Ste B, Charlotte, NC 28210 | 2015-06-07 |
| 1518346105 | Christopher Abernathy | Dentist | 3111 Springbank Ln Ste A, Charlotte, NC 28226 | 2015-05-28 |
| 1255737078 | Platte Valley Oral & Maxillofacial Surgery LLC | Dentist | 416 Valley View Drive, Suite 800, Scottsbluff, NC 69361-1420 | 2014-11-05 |
| 1780080655 | Robert L Stutts IIi Dmd Paii | Dentist | 200 E Wendover Ave Ste B, Greensboro, NC 27401-1227 | 2014-11-05 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.