Provider Demographics
NPI:1255087888
Name:CARLI WARDEN, DDS, PLLC
Entity type:Organization
Organization Name:CARLI WARDEN, DDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLI
Authorized Official - Middle Name:
Authorized Official - Last Name:WARDEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:980-423-1145
Mailing Address - Street 1:400 E STONEWALL ST UNIT 1301
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28202-3630
Mailing Address - Country:US
Mailing Address - Phone:757-816-5171
Mailing Address - Fax:
Practice Address - Street 1:3315 SPRINGBANK LN STE 200
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226-3198
Practice Address - Country:US
Practice Address - Phone:980-423-1145
Practice Address - Fax:980-423-1146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-22
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental