Provider Demographics
NPI:1124138409
Name:JOSHUA D PAYNICH DDS PA
Entity type:Organization
Organization Name:JOSHUA D PAYNICH DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:DAIN
Authorized Official - Last Name:PAYNICH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:828-274-4744
Mailing Address - Street 1:11 YORKSHIRE ST
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803
Mailing Address - Country:US
Mailing Address - Phone:828-628-9821
Mailing Address - Fax:828-274-4220
Practice Address - Street 1:11 YORKSHIRE ST
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803
Practice Address - Country:US
Practice Address - Phone:828-628-9821
Practice Address - Fax:828-274-4220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7473122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89902HXMedicaid
NC902HXOtherHEALTH CHOICE