Provider Demographics
NPI:1679205132
Name:COMPTON, CARLI SHAYNE (DMD)
Entity Type:Individual
Prefix:DR
First Name:CARLI
Middle Name:SHAYNE
Last Name:COMPTON
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:903 OBERLIN RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27605-1132
Mailing Address - Country:US
Mailing Address - Phone:910-526-4567
Mailing Address - Fax:
Practice Address - Street 1:3803 COMPUTER DR STE 200
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-6525
Practice Address - Country:US
Practice Address - Phone:919-786-6766
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-24
Last Update Date:2022-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC128451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice