Healthcare Provider Details

I. General information

NPI: 1902006646
Provider Name (Legal Business Name): CLAIRE SANGER DILLINGHAM D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2007
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1070 OLD STONE LN
KERNERSVILLE NC
27284-3852
US

IV. Provider business mailing address

PO BOX 602658
CHARLOTTE NC
28260-2658
US

V. Phone/Fax

Practice location:
  • Phone: 336-655-5550
  • Fax: 336-655-5550
Mailing address:
  • Phone: 336-716-2011
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number200300085
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number02009184A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: