Provider Demographics
NPI:1073532248
Name:DIMOCK WEINBERG & CHERRY DDS PLLC
Entity Type:Organization
Organization Name:DIMOCK WEINBERG & CHERRY DDS PLLC
Other - Org Name:DIMOCK AND WEINBERG D.D.S., PA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FINANCIAL COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:TERWILLIGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-794-2266
Mailing Address - Street 1:3505 CONVERSE DR
Mailing Address - Street 2:SUITE 175
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-6131
Mailing Address - Country:US
Mailing Address - Phone:910-794-2266
Mailing Address - Fax:910-794-6899
Practice Address - Street 1:3505 CONVERSE DR
Practice Address - Street 2:SUITE 175
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-6131
Practice Address - Country:US
Practice Address - Phone:910-794-2266
Practice Address - Fax:910-794-6899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC015ACOtherBLUE CROSS GROUP NUMBER
NC89015ACMedicaid