IDLEWILD FAMILY DENTISTRY, LLC (NPI# 1649783119) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649783119 |
| Entity Type | Organization |
| Organization Name | IDLEWILD FAMILY DENTISTRY, LLC |
| Other Organization Name | IDLEWILD FAMILY DENTISTRY |
| Practice Address |
4801 Indian Trail Fairview Rd Indian Trail NC 28079-8865 |
| Practice Telephone | 7048930351 |
| Practice Fax Number | 7048930354 |
| Mailing Telephone | 7048930351 |
| Mailing Fax Number | 7048930354 |
| Enumeration Date | 2017-11-07 |
| Last Update Date | 2017-11-07 |
| Authorized Official Name | DR. MITESH DHULAB (OWNER) |
| Authorized Official Telephone | 7048930351 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QS1200X |
Clinic/Center Specialization: Sleep Disorder Diagnostic |
Ambulatory Health Care Facilities | ||
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Other Name | Type Code |
|---|---|
| Idlewild Family Dentistry | Doing Business As Name - Organization |
| Street Address |
4801 INDIAN TRAIL FAIRVIEW RD |
| City | INDIAN TRAIL |
| State | NC |
| Zip Code | 28079-8865 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992297485 | Carolina Cala | Community/Behavioral Health | 3817 Balsam St, Indian Trail, NC 28079 | 2018-05-31 |
| 1992294805 | Dr Patel & Associates, Pa | Clinic/Center | 6046 W Highway 74, Indian Trail, NC 28079 | 2018-05-07 |
| 1306389085 | Creative Counseling and Consulting, LLC | Counselor | 4389 Indian Trail-fairview Road, Indian Trail, NC 28079 | 2016-11-29 |
| 1922481381 | Aakar Gaurang Chokshi | Dentist | 5850 W Highway 74 Ste 135, Indian Trail, NC 28079 | 2015-07-02 |
| 1881944536 | Francy Johana Rodriguez | Naturopath | 124 Unionville Indian Trail Rd W Ste A9, Indian Trail, NC 28079 | 2012-09-10 |
| 1669767653 | Leigh Ann Zimmerman Tasillo | Psychologist | 124 Unionville-indian Trail Rd., Suite B3, Indian Trail, NC 28079 | 2011-06-17 |
| 1679715650 | Indian Trail Chiropractic & Rehabilitation, Pa | Chiropractor | 100 Park Road East, Indian Trail, NC 28079 | 2009-04-06 |
| 1003079518 | Shemeeka L Mcfadden | Optometrist | 5850 Us-74, Unit 116, Indian Trail, NC 28079 | 2008-07-03 |
| 1023290046 | Gary Lee Vaughn | Technician/Technologist | 622 Indian Trail Rd, Indian Trail, NC 28079 | 2007-11-30 |
| 1750574331 | Susana C Junco | Dentist | 136 Indian Trail Rd, Indian Trail, NC 28079 | 2007-08-27 |
| Find all providers in zip 28079 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265816797 | Hasmi Patel | Dentist | 4514 Old Monroe Rd Ste E, Indian Trail, NC 28079-5308 | 2015-07-15 |
| 1366857989 | Infinity Dental Arts | Dentist | 6611 Old Monroe Road, Indian Trail, NC 28079-5352 | 2014-06-23 |
| 1033430046 | Milagros Diaz | Dentist | 6611 Old Monroe Rd, Indian Trail, NC 28079-5352 | 2010-06-14 |
| 1912136664 | R Barrows & Associates Pa | Dentist | 323 Unionville Indian Trl Rd W, Suite A, Indian Trail, NC 28079-7817 | 2009-07-02 |
| 1750574331 | Susana C Junco | Dentist | 136 Indian Trail Rd, Indian Trail, NC 28079 | 2007-08-27 |
| 1770607525 | Diego H. Gonzalez | Dentist | 1002 Cabra Ct, Indian Trail, NC 28079-5370 | 2007-03-19 |
| 1568545788 | Richard Mark Holmes | Dentist | 136 Indian Trail Rd S, Indian Trail, NC 28079-9669 | 2006-10-23 |
| 1780767822 | Sheena Devika Shukla Hauser | Dentist | 136 Indian Trail Rd S # B, Indian Trail, NC 28079-9669 | 2006-10-23 |
| 1144336959 | Sandra Merrill | Dentist | 331 Indian Trail Rd., N, Indian Trail, NC 28079 | 2006-08-22 |
| 1285262667 | Ganglani Dmd Pllc | Dentist | 6611 Old Monroe Rd, Indian Trail, NC 28079-5352 | 2020-03-31 |
| Find all providers in INDIAN TRAIL | ||||
| City | INDIAN TRAIL |
| Zip Code | 28079 |
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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.