Provider Demographics
NPI:1013074020
Name:POLLOCK, VALERIE C (DDS, PA)
Entity Type:Individual
Prefix:DR
First Name:VALERIE
Middle Name:C
Last Name:POLLOCK
Suffix:
Gender:F
Credentials:DDS, PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 874
Mailing Address - Street 2:
Mailing Address - City:BURGAW
Mailing Address - State:NC
Mailing Address - Zip Code:28425-0874
Mailing Address - Country:US
Mailing Address - Phone:910-259-2053
Mailing Address - Fax:910-259-2057
Practice Address - Street 1:302 S BENNETT ST
Practice Address - Street 2:
Practice Address - City:BURGAW
Practice Address - State:NC
Practice Address - Zip Code:28425
Practice Address - Country:US
Practice Address - Phone:910-259-2053
Practice Address - Fax:910-259-2057
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2017-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7419204E00000X, 207QS1201X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
No207QS1201XAllopathic & Osteopathic PhysiciansFamily MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC016FYOtherBCBS OF NC
NC1992881254OtherGROUP NPI
NC902E7OtherBCBS OF NC MEDICAL BILLING
NC89902E7Medicaid
NC1013074020OtherINDIVIDUAL NPI
NC89902E7Medicaid
NC016FYOtherBCBS OF NC