Provider Demographics
NPI:1851261903
Name:GODEL & ASSOCIATES II PLLC
Entity type:Organization
Organization Name:GODEL & ASSOCIATES II PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:
Authorized Official - Last Name:BEACH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-689-1412
Mailing Address - Street 1:417 WILLOW BROOK DR
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105-1831
Mailing Address - Country:US
Mailing Address - Phone:704-689-1412
Mailing Address - Fax:704-626-3096
Practice Address - Street 1:11010 S TRYON ST STE 101
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28273-0107
Practice Address - Country:US
Practice Address - Phone:704-686-8522
Practice Address - Fax:704-626-3096
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GODEL & ASSOCIATES II PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-11-05
Last Update Date:2025-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty