Provider Demographics
NPI:1376747469
Name:CYNTHIA N. ELDERKIN, D.D.S., P.A.
Entity Type:Organization
Organization Name:CYNTHIA N. ELDERKIN, D.D.S., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:NICHOLS
Authorized Official - Last Name:ELDERKIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:919-847-8747
Mailing Address - Street 1:8015 CREEDMOOR RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27613-4397
Mailing Address - Country:US
Mailing Address - Phone:919-847-8747
Mailing Address - Fax:
Practice Address - Street 1:8015 CREEDMOOR RD
Practice Address - Street 2:SUITE 202
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27613-4397
Practice Address - Country:US
Practice Address - Phone:919-847-8747
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-12
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5662122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty