Provider Demographics
NPI:1699266544
Name:CAPEL, MADISON JOHNSON BISSETTE (DDS)
Entity type:Individual
Prefix:DR
First Name:MADISON
Middle Name:JOHNSON BISSETTE
Last Name:CAPEL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92 STONEBRIDGE TRL
Mailing Address - Street 2:
Mailing Address - City:HAVELOCK
Mailing Address - State:NC
Mailing Address - Zip Code:28532-9553
Mailing Address - Country:US
Mailing Address - Phone:252-447-3100
Mailing Address - Fax:
Practice Address - Street 1:92 STONEBRIDGE TRL
Practice Address - Street 2:
Practice Address - City:HAVELOCK
Practice Address - State:NC
Practice Address - Zip Code:28532-9553
Practice Address - Country:US
Practice Address - Phone:252-447-3100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-27
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC109881223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC10988OtherNC DENTAL LICENSE