Healthcare Provider Details

I. General information

NPI: 1033762323
Provider Name (Legal Business Name): JOSHUA DAVID POLLACK DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2019
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1842 GALLERIA BLVD
CHARLOTTE NC
28270-2409
US

IV. Provider business mailing address

1842 GALLERIA BLVD
CHARLOTTE NC
28270-2409
US

V. Phone/Fax

Practice location:
  • Phone: 980-249-3993
  • Fax: 980-249-3992
Mailing address:
  • Phone: 980-249-3993
  • Fax: 980-249-3992

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number11586
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: