Provider Demographics
NPI:1174639512
Name:FLEMING, STANLEY LOUIS (DDS MS)
Entity Type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:LOUIS
Last Name:FLEMING
Suffix:
Gender:M
Credentials:DDS MS
Other - Prefix:
Other - First Name:STANLEY
Other - Middle Name:L
Other - Last Name:FLEMING
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS PA
Mailing Address - Street 1:601 FAYETTEVILLE ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27701
Mailing Address - Country:US
Mailing Address - Phone:919-688-8949
Mailing Address - Fax:919-688-6068
Practice Address - Street 1:601 FAYETTEVILLE ST
Practice Address - Street 2:SUITE 100
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27701
Practice Address - Country:US
Practice Address - Phone:919-688-8949
Practice Address - Fax:919-688-6068
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3995122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8992769Medicaid