CAROLINAS ORAL & FACIAL SURGERY CENTER, INC. (NPI# 1811033137) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811033137 |
| Entity Type | Organization |
| Organization Name | CAROLINAS ORAL & FACIAL SURGERY CENTER, INC. |
| Practice Address |
1122 Medical Center Dr Wilmington NC 28401-7305 |
| Practice Telephone | 9107622618 |
| Practice Fax Number | 9107635173 |
| Mailing Telephone | 9107622618 |
| Mailing Fax Number | 9107635173 |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2011-01-31 |
| Authorized Official Name | JANE M. PARENT (CFO) |
| Authorized Official Telephone | 9107622618 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
Dental Providers |
| Street Address |
1122 MEDICAL CENTER DR |
| City | WILMINGTON |
| State | NC |
| Zip Code | 28401-7305 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568463131 | Jeffrey Scott Church | Surgery | 1122 Medical Center Dr, Wilmington, NC 28401-7305 | 2005-08-09 |
| 1245709021 | La Belle Vie Plastic Surgery PC | Plastic Surgery | 1122 Medical Center Dr, Wilmington, NC 28401-7305 | 2018-11-21 |
| 1750553517 | Ronald D. Gaitros, Dds, Ms, Pa | Dentist | 1122 Medical Center Dr, Wilmington, NC 28401-7305 | 2008-04-01 |
| 1558533315 | Michael C. Kinnebrew, Md, Dds, Pa | Dentist | 1122 Medical Center Dr, Wilmington, NC 28401-7305 | 2008-04-01 |
| 1942298443 | Ronald Dale Gaitros | Dentist | 1122 Medical Center Dr, Wilmington, NC 28401-7305 | 2005-10-10 |
| 1346238862 | Michael Clark Kinnebrew | Dentist | 1122 Medical Center Dr, Wilmington, NC 28401-7305 | 2005-10-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275002461 | Thrivetothrive, LLC | Physical Therapist | 1606 Physicians Drive, Inside Promina Health, Wilmington, NC 28401 | 2018-11-16 |
| 1841787454 | Kevin Christopher Panebianco | Family Medicine | 1911 S 17th St Ste 130a, Wilmington, NC 28401 | 2018-04-18 |
| 1518472588 | Michelle Bruin | Family Medicine | 415 S. 2nd Street, Wilmington, NC 28401 | 2017-12-12 |
| 1639617343 | Anna Farwell | Behavior Technician | 3904 Oleander Dr. Suite 102, Wilmington, NC 28401 | 2017-02-02 |
| 1588034144 | Dimitri Zivko Pitovski | Allergy & Immunology | 1099 Medical Center Dr Unit 100b, Wilmington, NC 28401 | 2015-09-25 |
| 1629457007 | Megan Havel | Counselor | 1512 E Lakeshore Drive, Wilmington, NC 28401 | 2015-05-19 |
| 1154709251 | Lance Hutchens | Dentist | 1611 Doctors Cir, Wilmington, NC 28401 | 2015-05-11 |
| 1609281161 | Diane Pittman Whitford | Counselor | 313 Walnut St., Wilmington, NC 28401 | 2014-06-24 |
| 1942550728 | Bryan Cole Chalk | Nurse Anesthetist, Certified Registered | 2131 S 17th Street, Wilmington, NC 28401 | 2012-09-19 |
| 1740566546 | Valerie Baars | Pharmacist | 2302 S 17th Street, Wilmington, NC 28401 | 2011-10-25 |
| Find all providers in zip 28401 | ||||
| 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 |
|---|---|---|---|---|
| 1689224495 | Graham H. Wilson, Dds, Pa | Dentist | 7971 Market Street, Wilmington, NC 28411-9383 | 2019-09-13 |
| 1912200031 | John E Hickory | Dentist | 412 Ann St, Wilmington, NC 28401-4662 | 2010-12-11 |
| 1184941189 | Conrad, Arne', Lombardo, & Krupa, D.d.s, P.a. | Dentist | 7971 Market St, Wilmington, NC 28411-9383 | 2010-04-29 |
| 1689998304 | Gregg A. Lombardo, D.d.s., P.a. | Dentist | 1510 Medical Center Drive, Wilmington, NC 28401-7506 | 2010-03-24 |
| 1437321296 | Brady J. Semmel, Dmd, Md, Pa | Dentist | 1422 Commonwealth Drive, Wilmington, NC 28403-0302 | 2008-04-01 |
| 1811174352 | Douglas F. Degroote, Dds | Dentist | 2250 Shipyard Blvd Ste 15, Wilmington, NC 28403-8070 | 2008-01-28 |
| 1801001516 | David Dieu | Dentist | 1202 Foulk Road, Wilmington, DE 19803 | 2007-05-14 |
| 1043437825 | Michael Lee Hasson | Dentist | 1221 Floral Pkwy Ste 101, Wilmington, NC 28403-6235 | 2007-04-20 |
| 1306971882 | Shawn Conrad | Dentist | 1510 Medical Center Dr, Wilmington, NC 28401-7506 | 2007-02-23 |
| 1770639171 | Michael S. Booth | Dentist | 1305 Physicians Dr., Wilmington, NC 28401-7352 | 2007-01-26 |
| Find all providers in WILMINGTON | ||||
| City | WILMINGTON |
| Zip Code | 28401 |
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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.