Healthcare Provider Details

I. General information

NPI: 1114830445
Provider Name (Legal Business Name): ARIANNA COLLINS DA1
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2026
Last Update Date: 09/26/2026
Certification Date: 09/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 SE GREENVILLE BLVD
GREENVILLE NC
27858-4811
US

IV. Provider business mailing address

1000 FOWLER DR UNIT B
GREENVILLE NC
27834-3345
US

V. Phone/Fax

Practice location:
  • Phone: 252-375-8755
  • Fax:
Mailing address:
  • Phone: 336-469-6190
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code126800000X
TaxonomyDental Assistant
License Number
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: