Provider Demographics
NPI:1366916652
Name:IRONS, ELIZABETH FARRELL (DDS, MDS)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:FARRELL
Last Name:IRONS
Suffix:
Gender:F
Credentials:DDS, MDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6743 FAIRVIEW RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28210-3485
Mailing Address - Country:US
Mailing Address - Phone:704-366-2774
Mailing Address - Fax:
Practice Address - Street 1:6743 FAIRVIEW RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-3485
Practice Address - Country:US
Practice Address - Phone:704-366-2774
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-20
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL18651223G0001X
NC127711223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty
No1223G0001XDental ProvidersDentistGeneral Practice