Provider Demographics
NPI:1255020707
Name:BILLINGS, DALLAS MEGAN
Entity type:Individual
Prefix:
First Name:DALLAS
Middle Name:MEGAN
Last Name:BILLINGS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DALLAS
Other - Middle Name:MEGAN
Other - Last Name:DOLLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:108 RIDGE ST
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28052-6794
Mailing Address - Country:US
Mailing Address - Phone:704-777-6504
Mailing Address - Fax:
Practice Address - Street 1:2675 COURT DR
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-1478
Practice Address - Country:US
Practice Address - Phone:704-824-4999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-02
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNONE208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics