Southend Dentistry
LBN: Bradford L Picot, Dds, P.A.
Southend Dentistry is an health care organization with primary practice located at 1520 South Blvd Suite 110, Charlotte NC 28203-4786. The organization recently has 2 registered licenses in different health care specialties including Dental Providers / General Practice, Managed Care Organizations / Health Maintenance Organization. Dental Providers / General Practice is the primary health care specialty.
Bradford L Picot, Dds, P.A. can be contacted via phone (704) 335-8266, or through Picot, Bradford Lee via phone (704) 335-8266.
Contact Information
Primary practice address
1520 South Blvd Suite 110
Charlotte NC 28203-4786
Phone: (704) 335-8266
Fax: (704) 335-8267
Website:
Authorized official contact:
Name: Picot, Bradford Lee Doctor of Dental Surgery (DDS)
Phone: (704) 335-8266
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 8158 | North Carolina |
| Managed Care Organizations / Health Maintenance Organization | 302R00000X | 8158 | North Carolina |
Profile Details
| NPI number | 1003048752 |
|---|---|
| LBN Legal business name | Bradford L Picot, Dds, P.A. |
| DBA Doing business as | Southend Dentistry |
| Authorized official | Picot, Bradford Lee Doctor of Dental Surgery (DDS) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Aug 13th, 2009 |
| Last updated | Aug 13th, 2009 - about 15 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1003048752 | NPPES |
| North Carolina | MEDICAID | 5908420 |
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