Healthcare Provider Details

I. General information

NPI: 1013845767
Provider Name (Legal Business Name): CARSON STANLEY CHERRY DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1106 HILLANDALE RD
DURHAM NC
27705-3064
US

IV. Provider business mailing address

2312 VINTAGE HILL DR
DURHAM NC
27712-9474
US

V. Phone/Fax

Practice location:
  • Phone: 919-286-4488
  • Fax:
Mailing address:
  • Phone: 919-286-4488
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number1223G0001X
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: