MEDICARE: DR. STEPHANIE LEIGH HEANEY D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0221X	Pediatric Dentistry	7278	NC
2	122300000X	Dentist	7278	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1467516997
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHANIE LEIGH HEANEY D.D.S.

Provider Business Mailing Address
First Line	:	2606 IRON GATE DR STE 200
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28412-2494
Country	:	US
Telephone Number	:	910-791-7380
Fax Number	:	910-791-8160

Provider Business Practice Location Address
First Line	:	2606 IRON GATE DR
Second Line	:	SUITE 200
City	:	WILMINGTON
State	:	NC
Zip	:	28412-2573
Country	:	US
Telephone Number	:	910-791-7380
Fax Number	:	910-791-8160

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/20/2006
Last Update Date	:	12/11/2025

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Directions to “ DR. STEPHANIE LEIGH HEANEY D.D.S.” Practice Location

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