SOUTHSIDE UNITED HEALTH CENTERS (NPI# 1265911705) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265911705 |
| Entity Type | Organization |
| Organization Name | SOUTHSIDE UNITED HEALTH CENTERS |
| Practice Address |
2101 Peters Creek Pkwy Winston Salem NC 27127 |
| Mailing Address |
Po Box 12341 Winston Salem NC 27117-2341 |
| Practice Telephone | 3369551379 |
| Practice Fax Number | 3368939987 |
| Mailing Telephone | 3369551379 |
| Mailing Fax Number | 3368939987 |
| Enumeration Date | 2018-08-07 |
| Last Update Date | 2018-08-07 |
| Authorized Official Name | SHIRLEY KOTOFSKY (FINANCIAL SERVICES REPRESENTATIVE) |
| Authorized Official Telephone | 3369551379 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | NC | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861929523 | Southside United Health Centers | Social Worker | 3009 Waughtown St, Winston Salem, NC 27107 | 2017-05-12 |
| 1811136476 | Southside United Health Centers | Dentist | 3009 Waughtown St, Winston Salem, NC 27107-1634 | 2009-02-05 |
| Street Address |
2101 PETERS CREEK PKWY |
| City | WINSTON SALEM |
| State | NC |
| Zip Code | 27127 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568892016 | Shannon Kostuck | Social Worker | 2101 Peters Creek Pkwy, Suite 20-22, Winston Salem, NC 27127-3726 | 2013-11-20 |
| 1891274353 | Casey Reynolds | Dentist | 2101 Peters Creek Pkwy, Winston Salem, NC 27127-3726 | 2018-08-07 |
| 1730699224 | Erin Renee Brewer Ross | Physician Assistant | 2101 Peters Creek Pkwy, Winston Salem, NC 27127-3726 | 2017-10-10 |
| 1093225229 | Christopher Shane Georgeff | Family Medicine | 2101 Peters Creek Pkwy, Winston Salem, NC 27127-3726 | 2017-10-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821695164 | North Davidson Dialysis Center of Wake Forest University | Clinic/Center | 295 Millers Creek Drive, Winston Salem, NC 27127 | 2020-10-08 |
| 1326654963 | Procare Home Health, LLC | Home Health | 12133 Nc-150 Suite C, Winston-salem, NC 27127 | 2020-09-18 |
| 1952809576 | Lamboy and Rubio Dds Pa | Dentist | 2563 Peters Creek Pkwy, Winston Salem, NC 27127 | 2018-01-29 |
| 1427403815 | Ramona Rorie Griffin Noble | Counselor | 1348 Westgate Center Drive Suite 202, Winston Salem, NC 27127 | 2016-05-04 |
| 1205295680 | Kia Johnson | Dentist | 2101 Peters Creek Pkwy Ste 16-19, Winston Salem, NC 27127 | 2016-02-15 |
| 1487030060 | Llibott Consultorios Medicos- Ws,pllc | Clinic/Center | 1145 Silas Creek Pkwy, Winston Salem, NC 27127 | 2015-08-05 |
| 1740688266 | Bonnie M. Clifton | Specialist/Technologist | 800 Salisbury Ridge Rd, Winston-salem, NC 27127 | 2014-12-16 |
| 1740606706 | Yen T Nguyen Dmd Pllc | Dentist | 2375 Brewer Road, Winston-salem, NC 27127 | 2014-03-13 |
| 1316254451 | Marquis D. Bailey | Specialist | 200 Alexander Preston Ln, Winston - Salem, NC 27127 | 2010-09-10 |
| 1093991234 | Independent Living Group Home, LLC | Custodial Care Facility | 924 Cloister Dr, Winston Salem, NC 27127 | 2008-01-17 |
| Find all providers in zip 27127 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548824907 | Hyung Won Lee | Dentist | 4550 Country Club Rd, Winston Salem, NC 27104-3518 | 2019-04-30 |
| 1396308268 | Willardean Carroll Jordandula | Dentist | 3200 Cumberland Rd, Winston Salem, NC 27105-3303 | 2019-04-17 |
| 1003307703 | Lisa R. Gaither Dmd P.a. | Dentist | 1027 Hanes Mall Blvd, Winston Salem, NC 27103-1310 | 2018-05-29 |
| 1033600382 | Alterman & Dhillon Piedmont, Pplc | Dentist | 336 E Hanes Mill Rd, Winston Salem, NC 27105 | 2018-05-22 |
| 1659727535 | Barry Devon Price | Dentist | 755 Highland Oaks Dr Ste 106, Winston Salem, NC 27103-7106 | 2016-05-10 |
| 1205295680 | Kia Johnson | Dentist | 2101 Peters Creek Pkwy Ste 16-19, Winston Salem, NC 27127 | 2016-02-15 |
| 1982009114 | William R. Warren Dds, Pa | Dentist | 2606 New Walkertown Rd., Winston Salem, NC 27101 | 2014-10-30 |
| 1447679956 | Andrew C Geer, Dds Pllc | Dentist | 3244 Reynolda Rd, Winston Salem, NC 27106-3040 | 2014-04-11 |
| 1588080469 | Kimberly Pinyan | Dentist | 4712 Country Club Rd Ste C, Winston Salem, NC 27104-3749 | 2014-03-14 |
| 1053752055 | Katelyn Joyce Henderson | Dentist | 1480 Rymco Dr Ste A, Winston Salem, NC 27103-3072 | 2013-07-08 |
| Find all providers in WINSTON SALEM | ||||
| City | WINSTON SALEM |
| Zip Code | 27127 |
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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.