RANDALL O DUCK DDS PA (NPI# 1902084163) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902084163 |
| Entity Type | Organization |
| Organization Name | RANDALL O DUCK DDS PA |
| Practice Address |
3744 Vest Mill Rd Winston Salem NC 27103-2912 |
| Practice Telephone | 3367602501 |
| Practice Fax Number | 3367602192 |
| Mailing Telephone | 3367602501 |
| Mailing Fax Number | 3367602192 |
| Enumeration Date | 2008-02-09 |
| Last Update Date | 2008-02-09 |
| Authorized Official Name | DR. RANDALL OWEN DUCK (PRESIDENT) |
| Authorized Official Telephone | 3367602500 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
4630 | NC | Ambulatory Health Care Facilities |
| Street Address |
3744 VEST MILL RD |
| City | WINSTON SALEM |
| State | NC |
| Zip Code | 27103-2912 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396871240 | Randall Duck | Dentist | 3744 Vest Mill Rd, Winston Salem, NC 27103-2912 | 2007-02-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124648126 | Kelly Anne Wales | Pharmacist | 3917-a Westpoint Boulevard, Winston-salem, NC 27103 | 2020-04-20 |
| 1386281533 | Elena Mcginty | Nurse Practitioner | 1225 Creekshire Way, Suite 270, Winston Salem, NC 27103 | 2019-12-06 |
| 1992359442 | Madeline Pryor | Pharmacist | 255 Charlois Drive, Winston Salem, NC 27103 | 2019-08-01 |
| 1215599584 | Palmetto Oxygen LLC | Durable Medical Equipment & Medical Supplies | 1100 S Stratford Road, Building B, Suite 420, Winston Salem, NC 27103 | 2019-07-07 |
| 1548734718 | Trivy Johnson | Specialist | 1384-b Westgate Center Dr., Winston Salem, NC 27103 | 2019-01-21 |
| 1447745047 | Novant Health Rehabilitation Hospital of Winston-salem, LLC | Rehabilitation Hospital | 2475 Hillcrest Center Circle, Winston Salem, NC 27103 | 2018-06-26 |
| 1346740206 | Joseph Miller | Physical Therapist | 1605 Westbrook Dr, Suite 103, Winston-salem, NC 27103 | 2018-02-17 |
| 1548779101 | Kristin Blow | Counselor | 3000 Bethesda Pl Ste 202, Winston Salem, NC 27103 | 2017-09-27 |
| 1891213443 | Alisha Dawn Wilson | Occupational Therapy Assistant | 2101 Homestead Hills Drive, Winston Salem, NC 27103 | 2017-09-05 |
| 1588186969 | Brandy Wilson | Social Worker | 153 Cameron Way Circle, Winston Salem, NC 27103 | 2017-07-07 |
| Find all providers in zip 27103 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114491529 | Kyle Taylor, Dds IIi, Pllc | Clinic/Center | 3015 Maplewood Ave Ste 100, Winston Salem, NC 27103-4075 | 2019-01-18 |
| 1114294527 | Sarah C. Shoaf, Dds, Med, Ms, PC | Clinic/Center | 1063 W Northwest Blvd, Winston Salem, NC 27101-1104 | 2011-11-30 |
| 1801053475 | Roger N Reynolds 111 Dds Ms Pa | Clinic/Center | 3809 Forrestgate Dr, Suite A, Winston Salem, NC 27103-2982 | 2008-05-20 |
| 1518132109 | Robert M. Wilkinson, Jr., D.d.s., P.a. | Clinic/Center | 1086 Whitaker Rd, Winston Salem, NC 27106-4823 | 2008-04-24 |
| 1902884943 | Dr Matthew K Keider Dds Pa | Clinic/Center | 3610 Westgate Center Cir, Winston Salem, NC 27103-2935 | 2006-01-09 |
| 1841806387 | Samuel Bartlett Dds, Pllc | Clinic/Center | 3309 Healy Dr Ste B, Winston Salem, NC 27103-1474 | 2020-09-21 |
| 1184241622 | Jeffrey C. Zackeru, Dmd, Pllc | Clinic/Center | 481 Shepherd St, Winston Salem, NC 27103-1627 | 2020-07-01 |
| 1669097903 | Drs J Loveland and R Walker II, Pllc | Clinic/Center | 4622 Country Club Rd, Winston Salem, NC 27104-3769 | 2020-06-12 |
| 1437795465 | Wake Forest University Health Sciences | Clinic/Center | Medical Center Blvd, Winston Salem, NC 27157-0001 | 2019-11-25 |
| 1285120816 | United Health Centers | Clinic/Center | 2101 Peters Creek Pkwy Ste 16-19, Winston Salem, NC 27127-3726 | 2018-07-06 |
| Find all providers in WINSTON SALEM | ||||
| City | WINSTON SALEM |
| Zip Code | 27103 |
Please comment or provide details below to improve the information on RANDALL O DUCK DDS PA.
| 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.