MEDICARE: THOMAS J VERALDI DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0221X	Pediatric Dentistry	0215	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	0215	OTHER	NC	NC LICENSE

General Provider Information

NPI Number	:	1811943616
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS J VERALDI DMD

Provider Business Mailing Address
First Line	:	PO BOX 602790
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28260-2790
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1851 MACGREGOR DOWNS RD
Second Line	:
City	:	GREENVILLE
State	:	NC
Zip	:	27834-5925
Country	:	US
Telephone Number	:	252-737-7000
Fax Number	:	252-737-7198

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/25/2006
Last Update Date	:	01/22/2020

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