Healthcare Provider Details

I. General information

NPI: 1811136476
Provider Name (Legal Business Name): UNITED HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2009
Last Update Date: 10/22/2025
Certification Date: 10/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 PETERS CREEK PKWY STE 16-19
WINSTON SALEM NC
27127-3726
US

IV. Provider business mailing address

PO BOX 12341
WINSTON SALEM NC
27117-2341
US

V. Phone/Fax

Practice location:
  • Phone: 336-955-1379
  • Fax: 336-893-9987
Mailing address:
  • Phone: 336-293-8728
  • Fax: 336-293-8733

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: RODERIC BROWN
Title or Position: CEO
Credential:
Phone: 336-955-1379