MEDICARE: DR. TINA FIELDS POMPEY DDS

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	1223G0001X	General Practice Dentistry	6789	NC
2	122300000X	Dentist	6789	NC

General Provider Information

NPI Number	:	1679787444
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TINA FIELDS POMPEY DDS

Provider Business Mailing Address
First Line	:	6640 OLD MONROE RD STE A
Second Line	:
City	:	INDIAN TRAIL
State	:	NC
Zip	:	28079-5360
Country	:	US
Telephone Number	:	704-282-0600
Fax Number	:

Provider Business Practice Location Address
First Line	:	6640 OLD MONROE RD STE A
Second Line	:
City	:	INDIAN TRAIL
State	:	NC
Zip	:	28079-5360
Country	:	US
Telephone Number	:	704-282-0600
Fax Number	:

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

Provider Enumeration Date	:	05/10/2007
Last Update Date	:	05/08/2024

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