Healthcare Provider Details
I. General information
NPI: 1972445252
Provider Name (Legal Business Name): PRISCILLA CARPENTER LOCKHART, D.D.S., M.S., P.L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/07/2026
Last Update Date: 04/07/2026
Certification Date: 04/07/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2015 AYRSLEY TOWN BLVD STE 109A
CHARLOTTE NC
28273-4068
US
IV. Provider business mailing address
2015 AYRSLEY TOWN BLVD STE 109A
CHARLOTTE NC
28273-4068
US
V. Phone/Fax
- Phone: 704-208-4900
- Fax: 704-208-4914
- Phone: 704-208-4900
- Fax: 704-208-4914
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223E0200X |
| Taxonomy | Endodontics |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1223G0001X |
| Taxonomy | General Practice Dentistry |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
PRISCILLA
C
LOCKHART
Title or Position: OWNER DENTIST
Credential: DDS, MS
Phone: 704-208-4900