Healthcare Provider Details

I. General information

NPI: 1639329295
Provider Name (Legal Business Name): TAMEKO TOMPKINS SOWELL DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2008
Last Update Date: 02/24/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

890 SUMMIT CROSSING PL
GASTONIA NC
28054-2192
US

IV. Provider business mailing address

991 W HUDSON BLVD
GASTONIA NC
28052-6430
US

V. Phone/Fax

Practice location:
  • Phone: 704-874-0345
  • Fax:
Mailing address:
  • Phone: 704-853-5294
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number6487273
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License Number8878
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: