Healthcare Provider Details

I. General information

NPI: 1730277633
Provider Name (Legal Business Name): MARGERY R LEWIS D.M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 MILLER ST UNIVERSITY DENTAL ASSOCIATES
WINSTON SALEM NC
27103-2508
US

IV. Provider business mailing address

1720 CROSSFIELD RIDGE LN
WINSTON SALEM NC
27127-7432
US

V. Phone/Fax

Practice location:
  • Phone: 336-716-2183
  • Fax:
Mailing address:
  • Phone: 366-499-7093
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDS036833
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number150550
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: