Provider Demographics
NPI:1992491666
Name:GODEL & ASSOCIATES LLL PLLC
Entity type:Organization
Organization Name:GODEL & ASSOCIATES LLL PLLC
Other - Org Name:<UNAVAIL>
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 1:6655 E WILKINSON BLVD
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:NC
Mailing Address - Zip Code:28012-4706
Mailing Address - Country:US
Mailing Address - Phone:704-689-1412
Mailing Address - Fax:704-626-3096
Practice Address - Street 1:121 S ESTES DR STE 206
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-2868
Practice Address - Country:US
Practice Address - Phone:704-689-1412
Practice Address - Fax:704-626-3096
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHAPEL HILL FAMILY DENTAL CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-04-14
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No122300000XDental ProvidersDentistGroup - Multi-Specialty
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDentalGroup - Multi-Specialty