Provider Demographics
NPI:1942286208
Name:DODD, KARY V (DDSPA)
Entity type:Individual
Prefix:DR
First Name:KARY
Middle Name:V
Last Name:DODD
Suffix:
Gender:M
Credentials:DDSPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1610 VAUGHN RD
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27217-2919
Mailing Address - Country:US
Mailing Address - Phone:336-226-2525
Mailing Address - Fax:
Practice Address - Street 1:1610 VAUGHN RD
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27217-2864
Practice Address - Country:US
Practice Address - Phone:336-226-2525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5284122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8992192Medicaid
NCU37698Medicare UPIN