Healthcare Provider Details

I. General information

NPI: 1932010717
Provider Name (Legal Business Name): ADIL MEMON DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 FLOWERS COMMERCE DR
CLAYTON NC
27527-5491
US

IV. Provider business mailing address

50 FLOWERS COMMERCE DR
CLAYTON NC
27527-5491
US

V. Phone/Fax

Practice location:
  • Phone: 984-203-9501
  • Fax:
Mailing address:
  • Phone: 984-203-9501
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number14978
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: