SKIP TYSON DDS & STEPHANIE HEANEY DDS PA (NPI# 1083886345) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083886345 |
| Entity Type | Organization |
| Organization Name | SKIP TYSON DDS & STEPHANIE HEANEY DDS PA |
| Practice Address |
2606 Iron Gate Dr Suite 200 Wilmington NC 28412-2573 |
| Practice Telephone | 9107917380 |
| Mailing Telephone | 9107917380 |
| Enumeration Date | 2008-03-27 |
| Last Update Date | 2008-03-27 |
| Authorized Official Name | STEPHANIE HEANEY (OWNER) |
| Authorized Official Telephone | 9107917380 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
7278 | NC | Dental Providers |
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
6504 | NC | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 89903C | 05 | |
| NC | BCBS | 9003C | 01 |
| Street Address |
2606 IRON GATE DR SUITE 200 |
| City | WILMINGTON |
| State | NC |
| Zip Code | 28412-2573 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497724991 | Coastal Carolina Pathology, Pa | Clinical Medical Laboratory | 2606 Iron Gate Dr, Suite 201, Wilmington, NC 28412-2573 | 2006-03-16 |
| 1033380423 | Gregory L. Richardson Dds.ms.pa | Exclusive Provider Organization | 2606 Iron Gate Dr, Suite 101, Wilmington, NC 28412-2573 | 2008-03-13 |
| 1861537664 | Warren C White | Pathology | 2606 Iron Gate Dr, Suite 201, Wilmington, NC 28412-2573 | 2007-02-20 |
| 1003970534 | Chester J Tyson Iv | Dentist | 2606 Iron Gate Dr, Suite 200, Wilmington, NC 28412-2573 | 2006-12-20 |
| 1467516997 | Stephanie Leigh Freccia | Dentist | 2606 Iron Gate Dr, Suite 200, Wilmington, NC 28412-2573 | 2006-12-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891357166 | Alexandra Palamaru | Dentist | 2759, 6132 Carolina Beach Rd., 6, Wilmington, NC 28412 | 2019-07-08 |
| 1447640115 | Carrie Anne Emory | Physician Assistant | 1124 Gallery Park Blvd, #200, Wilmington, NC 28412 | 2015-02-02 |
| 1144639295 | Christina Marie Terry | Physical Therapist | 7842 Champlain Dr, Wilmington, NC 28412 | 2014-08-03 |
| 1972889715 | New Hanover House, LLC | Assisted Living Facility | 3915 Stedwick Court, Wilmington, NC 28412 | 2011-10-25 |
| 1538440672 | Celine Adair | Marriage & Family Therapist | 9809 River Rd, Wilmington, NC 28412 | 2011-09-02 |
| 1033412267 | American Anesthesiology of North Carolina, Pllc | Anesthesiology | 2520 Independence Blvd, Suite 200, Wilmington, NC 28412 | 2010-12-09 |
| 1932418357 | Dale Autry | Pharmacist | 3625 South College Road, Wilmington, NC 28412 | 2010-10-04 |
| 1528390762 | Sheila Flynn | Counselor | 710 St. Andrews Dr. #18, Wilmington, NC 28412 | 2010-02-12 |
| 1952563686 | Stephen Rolfe Wells | Anesthesiology | 2520 Independence Boulevard, Suite 200, Wilmington, NC 28412 | 2008-06-25 |
| 1396902722 | Henry D Browning Iv | Dentist | 604 Junction Creek, Wilmington, NC 28412 | 2008-05-22 |
| Find all providers in zip 28412 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740849744 | Riccobene & Associates Xxx, Dds, P.a. | Dentist | 8203 Market St Bldg B, Wilmington, NC 28411-9389 | 2019-06-12 |
| 1083189609 | Children's Dental Health of Delaware, LLC | Dentist | 3301 Lancaster Pike # 3e3f, Wilmington, DE 19805-1436 | 2018-10-10 |
| 1427567379 | Mid-atlantic Dental Partners Delaware II Professional Associates | Dentist | 4201 Miller Rd, Wilmington, DE 19802-1914 | 2017-09-22 |
| 1013381409 | Wj Partnership | Dentist | 8115 Market St Ste 204, Wilmington, NC 28411-8430 | 2015-11-23 |
| 1003109877 | Jill Laurie Garrido | Dentist | 2000 Foulk Rd Ste C, Wilmington, DE 19810-3642 | 2011-05-26 |
| 1316095904 | B.b. Roseman Dmd, Md L.b Jacobs Dmd Pa | Dentist | 708 Foulk Rd, Wilmington, DE 19803-3734 | 2007-01-08 |
| 1790850675 | Robert Toms Kelly | Dentist | 1635 Doctors Cir, Wilmington, NC 28401-7405 | 2006-11-23 |
| 1316037799 | Halley R White | Dentist | 8115 Market St, Suite 204, Wilmington, NC 28411-8427 | 2006-10-13 |
| 1699884940 | Julia Dimock | Dentist | 3505 Converse Dr Ste 175, Wilmington, NC 28403-6174 | 2006-08-30 |
| 1073532248 | Dimock Weinberg & Cherry Dds Pllc | Dentist | 3505 Converse Dr, Suite 175, Wilmington, NC 28403-6131 | 2006-07-19 |
| Find all providers in WILMINGTON | ||||
| City | WILMINGTON |
| Zip Code | 28412 |
Please comment or provide details below to improve the information on SKIP TYSON DDS & STEPHANIE HEANEY 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.