Healthcare Provider Details

I. General information

NPI: 1205121662
Provider Name (Legal Business Name): NATHAN WILLIAM SOMMER DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/14/2011
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

775 TARBORO ROAD STE 155
YOUNGSVILLE NC
27596
US

IV. Provider business mailing address

775 TARBORO ROAD STE 155
YOUNGSVILLE NC
27596
US

V. Phone/Fax

Practice location:
  • Phone: 919-263-2180
  • Fax: 919-263-2208
Mailing address:
  • Phone: 919-263-2180
  • Fax: 919-263-2208

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number6954
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number11658
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: