| Village Family Dental | |
|
2029 Valleygate Dr Suite 201 Fayetteville NC 28304-3688 | |
| (910) 485-8884 | |
| (910) 485-8287 |
| Full Name | Village Family Dental |
|---|---|
| Speciality | Dentist |
| Location | 2029 Valleygate Dr, Fayetteville, North Carolina |
| Authorized Official Name and Position | Michael John Knowles (OWNER) |
| Authorized Official Contact | 9104858884 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Village Family Dental 2029 Valleygate Dr Suite 201 Fayetteville NC 28304-3688 Ph: (910) 485-8884 | Village Family Dental 2029 Valleygate Dr Suite 201 Fayetteville NC 28304-3688 Ph: (910) 485-8884 |
| NPI Number | 1750495693 |
|---|---|
| Provider Enumeration Date | 08/18/2006 |
| Last Update Date | 01/12/2016 |
| Medicare PECOS PAC ID | 8628399227 |
|---|---|
| Medicare Enrollment ID | O20150608002836 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750495693 | NPI | - | NPPES |
| 890289B | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
| Provider Name | Grant Wiles |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1083728745 PECOS PAC ID: 2961432984 Enrollment ID: I20050818000563 |
| Provider Name | Kushan Patel |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1831593599 PECOS PAC ID: 2567783087 Enrollment ID: I20150609000568 |
| Provider Name | Bradley C Ryan |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1427162163 PECOS PAC ID: 3971824574 Enrollment ID: I20150609001044 |
| Provider Name | Gary Hall |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1437255387 PECOS PAC ID: 8729309273 Enrollment ID: I20150609001199 |
| Provider Name | Andrea Jacobs |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1669793873 PECOS PAC ID: 2062733512 Enrollment ID: I20150609001311 |
| Provider Name | Anne Phyllis Dodds |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1619135811 PECOS PAC ID: 7214258789 Enrollment ID: I20150609001752 |
| Provider Name | Sunny Yu |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1396841227 PECOS PAC ID: 1456672922 Enrollment ID: I20150609001889 |
| Provider Name | Harold Coe |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1023030863 PECOS PAC ID: 1052632528 Enrollment ID: I20150609002007 |
| Provider Name | Daniel Mcinnis |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1467472100 PECOS PAC ID: 6103147483 Enrollment ID: I20150611002960 |
| Provider Name | Jordan Olsen |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1326350547 PECOS PAC ID: 5395056618 Enrollment ID: I20150612001093 |
| Provider Name | Molly Guy |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1164743191 PECOS PAC ID: 3870804107 Enrollment ID: I20150612001371 |
| Provider Name | Terrance Smith |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1235235169 PECOS PAC ID: 2163743766 Enrollment ID: I20150612002498 |
| Provider Name | Martin Oakes |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1568568467 PECOS PAC ID: 1759692023 Enrollment ID: I20150613000019 |
| Provider Name | Anuj James |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1447356381 PECOS PAC ID: 9335460930 Enrollment ID: I20150714000253 |
| Provider Name | Plummer R Chavis |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1538594866 PECOS PAC ID: 5698849412 Enrollment ID: I20160204000668 |
| Provider Name | Azure Utley |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1871563759 PECOS PAC ID: 4688978646 Enrollment ID: I20160211001464 |
| Provider Name | Pawandip Singh |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1447302112 PECOS PAC ID: 7618271453 Enrollment ID: I20160215001951 |
| Provider Name | Margaret Floor |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1811376981 PECOS PAC ID: 4688979404 Enrollment ID: I20160216001842 |
| Provider Name | Thomas Mcdaniel |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1679985196 PECOS PAC ID: 9830494665 Enrollment ID: I20160216001930 |
| Provider Name | Anthony Maiorana |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1538220223 PECOS PAC ID: 6406151232 Enrollment ID: I20160216002186 |
| Provider Name | Daniel Ravel |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1033329941 PECOS PAC ID: 2567767312 Enrollment ID: I20160216002699 |
| Provider Name | Nathan Abramson |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1457505869 PECOS PAC ID: 2062717788 Enrollment ID: I20160217002475 |
| Provider Name | Michael J Knowles |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1568569697 PECOS PAC ID: 5890016497 Enrollment ID: I20160218001687 |
| Provider Name | Mit Patel |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1548496490 PECOS PAC ID: 8426379033 Enrollment ID: I20160225002575 |
| Provider Name | Lauren Brannon |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1023114972 PECOS PAC ID: 1153604608 Enrollment ID: I20170208001303 |
| Provider Name | Herald H Hughes |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1851479836 PECOS PAC ID: 0143516583 Enrollment ID: I20170329002498 |
| Provider Name | Hal G Fogleman |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1366536955 PECOS PAC ID: 2769701861 Enrollment ID: I20170404000277 |
| Provider Name | Lacolis Reed |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1770739427 PECOS PAC ID: 2264705425 Enrollment ID: I20170911000178 |
| Provider Name | Trang T Nguyen |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1477943231 PECOS PAC ID: 6406122357 Enrollment ID: I20171021000042 |
| Provider Name | Dahlia Michael |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1205099645 PECOS PAC ID: 1052690906 Enrollment ID: I20171108003571 |
| Provider Name | Brittany Williams Burkhard |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1932693066 PECOS PAC ID: 9931445707 Enrollment ID: I20190115003455 |
| Provider Name | Jeffrey Edward Aycock |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1568693877 PECOS PAC ID: 6204103591 Enrollment ID: I20191001002655 |
| Provider Name | Elizabeth Lauren Campbell |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1316353956 PECOS PAC ID: 9931499035 Enrollment ID: I20191203002037 |
| Provider Name | Lashawn J Hart |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1427614031 PECOS PAC ID: 9234563511 Enrollment ID: I20191218003357 |
| Provider Name | Nejmeh N Shahbazi |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1588051460 PECOS PAC ID: 8224462213 Enrollment ID: I20191228000269 |
| Provider Name | Puja N Patel |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1962063875 PECOS PAC ID: 6901230689 Enrollment ID: I20200106002189 |
| Provider Name | Elizabeth D Hincks |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1811555295 PECOS PAC ID: 9335576339 Enrollment ID: I20200304001879 |
| Provider Name | Melinda E Cunningham |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1437636826 PECOS PAC ID: 5294162194 Enrollment ID: I20200304002601 |
| Provider Name | Shannyn Little |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1699335950 PECOS PAC ID: 0446689566 Enrollment ID: I20200410000246 |
| Provider Name | Barry D Barger |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1215949821 PECOS PAC ID: 0749610160 Enrollment ID: I20200424002280 |
| Provider Name | Kerolos R Elsayed |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1497266092 PECOS PAC ID: 6305102732 Enrollment ID: I20200519002598 |
Pine Valley Family Dentistry Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1661 Owen Dr, Fayetteville, NC 28304 Phone: 910-485-2273 Fax: 910-485-0772 | |
Valleygate Dental Surgery Center Dental Clinic Medicare: Medicare Enrolled Practice Location: 2038 Litho Place, Fayetteville, NC 28304 Phone: 910-485-7070 Fax: 910-485-1151 | |
Dentalworks Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 7780 South Raeford Road, Fayetteville, NC 28304 Phone: 972-755-0800 Fax: 972-755-0800 | |
Knowles, Smith & Associates, Llp Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2409 Robeson St, Fayetteville, NC 28305 Phone: 910-483-9546 | |
Brush And Floss Specialty-raeford Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 6950 Nexus Ct, Fayetteville, NC 28304 Phone: 910-864-2400 Fax: 910-864-3016 | |
Day And Night Family Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1408 Skibo Rd., Fayetteville, NC 28303 Phone: 910-922-9989 | |
Village Family Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2028 Litho Pl Ste 300, Fayetteville, NC 28304 Phone: 910-485-7070 Fax: 910-485-1151 |