Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
WILLIAM SUMMERVILLE DDS PLLC
Active
Organization
WILLIAM SUMMERVILLE DDS PLLC
Active
Other names
Distinctive Dentistry of Charlotte
Organization subpart
No
Provider details
NPI number
Authorized official
MARY BLANKENSHIP (OFFICE MANAGER)
(704) 540-5400
Entity
Organization
Contact information
Practice address
475 N WENDOVER RD, CHARLOTTE, NC 28211-1064
(704) 540-5400
(704) 364-5293
Mailing address
475 N WENDOVER RD, CHARLOTTE, NC 28211-1064
(704) 540-5400
(704) 364-5293
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
018X3
BCBS OF NCNCHEALTHCHOICE
NC
05
—
5906062
—
NC
Enumeration date
06/02/2006
Last updated
05/11/2021
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up