Provider Demographics
NPI:1952559502
Name:NUNES, JOANNE MARTINS (DMD)
Entity type:Individual
Prefix:DR
First Name:JOANNE
Middle Name:MARTINS
Last Name:NUNES
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 1:2015 VALLEYGATE DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-3757
Mailing Address - Country:US
Mailing Address - Phone:910-485-7070
Mailing Address - Fax:910-485-1151
Practice Address - Street 1:2029 VALLEYGATE DR
Practice Address - Street 2:SUITE 201
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-3771
Practice Address - Country:US
Practice Address - Phone:910-485-8884
Practice Address - Fax:910-485-8287
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-08
Last Update Date:2012-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN18333122300000X
NC9147122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5918555Medicaid