Provider Demographics
NPI:1346986262
Name:WINSHIP, COREY J (DMD)
Entity Type:Individual
Prefix:DR
First Name:COREY
Middle Name:J
Last Name:WINSHIP
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:482 BROAD ST APT 2
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-6608
Mailing Address - Country:US
Mailing Address - Phone:603-479-5526
Mailing Address - Fax:
Practice Address - Street 1:1950 LAFAYETTE RD STE 301
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-8864
Practice Address - Country:US
Practice Address - Phone:603-479-5526
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-12
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MADL15304122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program