Provider Demographics
NPI:1922024702
Name:CAPARELLI & MELLIS DDS PLLC
Entity type:Organization
Organization Name:CAPARELLI & MELLIS DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:INGLE
Authorized Official - Last Name:CAPARELLI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:910-392-2920
Mailing Address - Street 1:910 S COLLEGE RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-4412
Mailing Address - Country:US
Mailing Address - Phone:910-392-2920
Mailing Address - Fax:910-392-2221
Practice Address - Street 1:910 S COLLEGE RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-4412
Practice Address - Country:US
Practice Address - Phone:910-392-2920
Practice Address - Fax:910-392-2221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6831122300000X
NC7011122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89014 PCMedicaid