Provider Demographics
NPI:1598247579
Name:S. VAKIL DDS MS I, PA
Entity Type:Organization
Organization Name:S. VAKIL DDS MS I, PA
Other - Org Name:GROWING SMILES PEDIATRIC DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAMIK
Authorized Official - Middle Name:S
Authorized Official - Last Name:VAKIL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:919-357-2288
Mailing Address - Street 1:308 IVERSON WAY
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28203-5631
Mailing Address - Country:US
Mailing Address - Phone:919-357-2288
Mailing Address - Fax:
Practice Address - Street 1:6331 CARMEL RD STE 101
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226-8246
Practice Address - Country:US
Practice Address - Phone:704-741-3070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-05
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC86671223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty