Healthcare Provider Details

I. General information

NPI: 1700701711
Provider Name (Legal Business Name): AMY LEWIS DDS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8115 MARKET ST STE 204
WILMINGTON NC
28411-8430
US

IV. Provider business mailing address

1013 CRANFORD DR
WILMINGTON NC
28411-1500
US

V. Phone/Fax

Practice location:
  • Phone: 304-208-6277
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State

VIII. Authorized Official

Name: AMY LEWIS
Title or Position: PEDIATRIC DENTIST
Credential: DDS
Phone: 304-208-6277