Healthcare Provider Details

I. General information

NPI: 1073439014
Provider Name (Legal Business Name): AMY LYNNE CARTER RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 PAVERSTONE DR
RALEIGH NC
27615-4709
US

IV. Provider business mailing address

8625 REINDEER MOSS DR
WAKE FOREST NC
27587-4837
US

V. Phone/Fax

Practice location:
  • Phone: 919-847-8413
  • Fax:
Mailing address:
  • Phone: 919-605-1882
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number11250
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: