Healthcare Provider Details

I. General information

NPI: 1083235345
Provider Name (Legal Business Name): VIVIAN A THROOP DDS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2020
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5109 BUR OAK CIR STE 100
RALEIGH NC
27612-3101
US

IV. Provider business mailing address

5109 BUR OAK CIR STE 100
RALEIGH NC
27612-3101
US

V. Phone/Fax

Practice location:
  • Phone: 919-787-4915
  • Fax: 919-788-7606
Mailing address:
  • Phone: 919-787-4915
  • Fax: 919-788-7606

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: DR. VIVIAN THROOP
Title or Position: OWNER
Credential: DDS
Phone: 919-259-6728