DR. LUIS FELIPE MIRANDA, D.M.D. - NPI NUMBER 1902238496

Summary

Provider Name: DR. LUIS FELIPE MIRANDA, D.M.D.

NPI Number: 1902238496

Clasification: Dentist (1223G0001X)

Specialization: General Practice

Address:
1161 N ROAD ST
ELIZABETH CITY, NC
ZIP 27909

Phone Number: (252) 737-7250



Detailed Information

DR. Luis Felipe Miranda, D.M.D. is a general practice dentist in Elizabeth City, NC. The provider is 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. The assigned NPI number for this provider is 1902238496 and is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business address is:

1161 N ROAD ST
ELIZABETH CITY, NC
ZIP 27909-388
Phone: (252) 737-7250

The enumeration date for this NPI number is 8/6/2013 and was last updated on 8/6/2013.

Map - Location of Practice

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Taxonomy Codes

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 1223G0001X Dentist General Practice 150951 NC Yes

NPI Record

No. Field Name Field Value
1 NPI 1902238496
2 Entity Type Code 1
3 Provider Last Name Legal Name MIRANDA
4 Provider First Name LUIS
5 Provider Middle Name FELIPE
6 Provider Name Prefix Text DR.
7 Provider Credential Text D.M.D.
8 Provider First Line Business Practice Location Address 1161 N ROAD ST
9 Provider Business Practice Location Address City Name ELIZABETH CITY
10 Provider Business Practice Location Address State Name NC
11 Provider Business Practice Location Address Postal Code 279093388
12 Provider Business Practice Location Address Country Code If outside U S US
13 Provider Business Practice Location Address Telephone Number 2527377250
14 Provider Enumeration Date 8/6/2013
15 Last Update Date 8/6/2013
16 Provider Gender Code M
17 Healthcare Provider Taxonomy Code 1 1223G0001X
18 Provider License Number 1 150951
19 Provider License Number State Code 1 NC
20 Healthcare Provider Primary Taxonomy Switch 1 Y
21 Is Sole Proprietor N

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This page was last updated on: 9/11/2014
All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.