Provider Demographics
NPI:1073091658
Name:SAMIR J NAIK, DDSII, PLLC
Entity Type:Organization
Organization Name:SAMIR J NAIK, DDSII, PLLC
Other - Org Name:SOUTHPOINT FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMIR
Authorized Official - Middle Name:J
Authorized Official - Last Name:NAIK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:571-331-6962
Mailing Address - Street 1:9105 CLUB HILL DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27617-8433
Mailing Address - Country:US
Mailing Address - Phone:571-331-6962
Mailing Address - Fax:
Practice Address - Street 1:1208 RIDDLE RD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-1294
Practice Address - Country:US
Practice Address - Phone:919-682-9707
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-05
Last Update Date:2018-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
122300000X
NC9478261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDentalGroup - Single Specialty