Provider Demographics
NPI:1699876169
Name:WARD, JOHN CARTER (DDS)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:CARTER
Last Name:WARD
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6570 SHALLOWFORD RD
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27023-8651
Mailing Address - Country:US
Mailing Address - Phone:336-945-5555
Mailing Address - Fax:336-945-0125
Practice Address - Street 1:6570 SHALLOWFORD RD
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:NC
Practice Address - Zip Code:27023-8651
Practice Address - Country:US
Practice Address - Phone:336-945-5555
Practice Address - Fax:336-945-0125
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7664122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8902KJMedicaid