Healthcare Provider Details

I. General information

NPI: 1164376414
Provider Name (Legal Business Name): AMY LI DMD 3 PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5510 W FRIENDLY AVE
GREENSBORO NC
27410-4212
US

IV. Provider business mailing address

149 YADKIN VALLEY RD STE 101
ADVANCE NC
27006-8782
US

V. Phone/Fax

Practice location:
  • Phone: 336-998-1076
  • Fax:
Mailing address:
  • Phone: 336-998-1076
  • Fax: 336-998-3314

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number StateNULL

VIII. Authorized Official

Name: AMY S LI
Title or Position: DENTIST
Credential: DMD
Phone: 336-998-1076