WILMINGTON AESTHETIC FACIAL PLASTIC AND RECONSTRUCTIVE CENTER, LLC (NPI# 1316202948) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316202948 |
| Entity Type | Organization |
| Organization Name | WILMINGTON AESTHETIC FACIAL PLASTIC AND RECONSTRUCTIVE CENTER, LLC |
| Practice Address |
1604 Physicians Dr 103 Wilmington NC 28401-7362 |
| Practice Telephone | 9107621070 |
| Practice Fax Number | 9107621083 |
| Mailing Telephone | 9107621070 |
| Mailing Fax Number | 9107621083 |
| Enumeration Date | 2012-07-10 |
| Last Update Date | 2012-07-26 |
| Authorized Official Name | DR. DEIDRA A BLANKS (OWNER) |
| Authorized Official Telephone | 9107621070 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207YS0123X |
Otolaryngology Specialization: Facial Plastic Surgery |
2006-00621 | NC | Allopathic & Osteopathic Physicians |
| Street Address |
1604 PHYSICIANS DR 103 |
| City | WILMINGTON |
| State | NC |
| Zip Code | 28401-7362 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932298668 | Coastal Carolina Heart, LLC | Clinic/Center | 1604 Physicians Dr, Suite 104, Wilmington, NC 28401-7362 | 2006-10-12 |
| 1760870323 | Azalea Coast Podiatry and Foot Spa, Pllc | Podiatrist | 1604 Physicians Dr, Suite 105, Wilmington, NC 28401-7362 | 2015-01-06 |
| 1578868600 | Damon R Arne, Dds, Pa | Dentist | 1604 Physicians Dr, Suite 102, Wilmington, NC 28401-7362 | 2011-01-20 |
| 1447406327 | Azalea Coast Plastic Surgery, Pa | Clinic/Center | 1604 Physicians Dr, Suite 103, Wilmington, NC 28401-7362 | 2008-08-12 |
| 1245402064 | Coastal Carolina Heart LLC | Clinic/Center | 1604 Physicians Dr, Suite 104, Wilmington, NC 28401-7362 | 2008-04-01 |
| 1508036997 | Dr. Timothy H. Mihle | Dentist | 1604 Physicians Dr, Suite 101, Wilmington, NC 28401-7362 | 2008-03-03 |
| 1568664183 | Damon Ross Arne' | Dentist | 1604 Physicians Dr, Suite 102, Wilmington, NC 28401-7362 | 2007-06-05 |
| 1598834350 | Kerry Allyson Smith | Podiatrist | 1604 Physicians Dr, Suite 105, Wilmington, NC 28401-7362 | 2006-11-07 |
| 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 | 207YS0123X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| Specialization | Facial Plastic Surgery |
| An otolaryngologist who specializes in facial plastic surgery. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate was, but is no longer issued by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326481177 | Delaware Otolaryngology Consultants LLC | Otolaryngology | 700 Clayton Street, Wilmington, DE 19805-3165 | 2013-04-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740547595 | Carolina Facial Plastics Pllc | Otolaryngology | 6849 Fairview Rd Ste 200, Charlotte, NC 28210-3664 | 2012-04-18 |
| 1619272614 | Evergreen Ent & Facial Plastic Surgery, Pllc | Otolaryngology | 1086 Bethel Rd, Morganton, NC 28655-8100 | 2011-01-21 |
| 1124117486 | Jonathan Sol Kulbersh | Otolaryngology | 6849 Fairview Rd, Ste 200, Charlotte, NC 28210-3393 | 2006-10-12 |
| 1952348492 | Francis P. J. Langford | Otolaryngology | 645 Amalia St Ne, Concord, NC 28025-2434 | 2006-06-01 |
| 1033195144 | Erik L Kenyon | Otolaryngology | 333 Jefferson St, Whiteville, NC 28472-3601 | 2005-12-20 |
| 1679010011 | Triangle Plastic Surgery Center, Pllc | Otolaryngology | 9104 Falls of Neuse Rd, Suite 204, Raleigh, NC 27615-2494 | 2017-01-24 |
| 1750625927 | Goldman Center for Facial Plastic Surgery Pllc | Otolaryngology | 717 Greenway Rd, Suite A, Boone, NC 28607-4903 | 2012-11-12 |
| 1366793465 | Charlotte Eye Ear Nose & Throat Associates, Pa | Otolaryngology | 114 Gateway Blvd, Suite B, Mooresville, NC 28117-5598 | 2012-09-28 |
| 1639406598 | Daniel Robert Gerry | Otolaryngology | 1107 Reynolds St, Monroe, NC 28112-4351 | 2009-11-12 |
| 1215120357 | Andrea Jarchow Garcia | Otolaryngology | 1819 Lyndhurst Ave, Charlotte, NC 28203-5103 | 2007-08-22 |
| Find all providers with the same taxonomy | ||||
| City | WILMINGTON |
| Zip Code | 28401 |
Please comment or provide details below to improve the information on WILMINGTON AESTHETIC FACIAL PLASTIC AND RECONSTRUCTIVE CENTER, LLC.
| 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.