Provider Demographics
NPI:1306159389
Name:HOY, ELIZABETH LAUREN (DMD)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:LAUREN
Last Name:HOY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:ELIZABETH
Other - Middle Name:LAUREN
Other - Last Name:HOLLENBECK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:3014 BAUCOM RD STE 200
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28269-2393
Mailing Address - Country:US
Mailing Address - Phone:704-596-3186
Mailing Address - Fax:
Practice Address - Street 1:3014 BAUCOM RD STE 200
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28269-2393
Practice Address - Country:US
Practice Address - Phone:704-596-3186
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-20
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0383741223G0001X
NC10236122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC10236OtherNC DENTAL BOARD
PADS038374OtherDENTAL LICENSE