Healthcare Provider Details

I. General information

NPI: 1164147492
Provider Name (Legal Business Name): ASCEND EYE CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2022
Last Update Date: 04/24/2023
Certification Date: 04/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

755 HIGHLAND OAKS DR STE 202
WINSTON SALEM NC
27103-7106
US

IV. Provider business mailing address

755 HIGHLAND OAKS DR STE 202
WINSTON SALEM NC
27103-7106
US

V. Phone/Fax

Practice location:
  • Phone: 336-997-4599
  • Fax: 336-293-4758
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207WX0009X
TaxonomyGlaucoma Specialist (Ophthalmology) Physician
License Number
License Number State

VIII. Authorized Official

Name: JIAXI DING
Title or Position: OWNER
Credential: MD
Phone: 336-997-4599