DR. DALE A CHILDERS DDS NPI 1730272402

NPI Information

NPI: 1730272402
Provider Name: DR. DALE A CHILDERS, DDS
Classification: Dentist - 1223S0112X
Entity Type: Individual

Specialization: Oral and Maxillofacial Surgery

Address:
2409 ROBESON STREET
FAYETTEVILLE, NC
ZIP 28305
Phone: (910) 483-9546
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DR. Dale A Childers, DDS is an oral and maxillofacial surgery dentist in Fayetteville, NC. The provider is 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. DR. Dale A Childers, DDS NPI is 1730272402. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2409 ROBESON STREET
FAYETTEVILLE, NC
ZIP 28305
Phone: (910) 483-9546
Fax: (910) 483-8550

The enumeration date for this NPI number is 10/2/2006 and was last updated on 7/9/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	1223S0112X	Dentist	Oral and Maxillofacial Surgery	4973	NORTH CAROLINA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	T63841	MEDICARE UPIN	NORTH CAROLINA
2	241136A	MEDICARE ID-TYPE UNSPECIFIED	NORTH CAROLINA	INDIVIDUAL #
3	8991553	MEDICAID	NORTH CAROLINA
4	467383	OTHER	NORTH CAROLINA	INDIVIDUAL #-UNITED CONCO
5	2415242	MEDICARE ID-TYPE UNSPECIFIED	NORTH CAROLINA	GROUP #
6	955715	OTHER	NORTH CAROLINA	GROUP #-UNITED CONCORDIA
7	890138F	MEDICAID	NORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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