Tony Porter, DDS, PA
Dentist, General Practice in Winston-Salem, NC. Organization (NPI-2).
Details
- NPI
- 1174580294
- Entity type
- Organization (NPI-2)
- Legal business name
- Tony Porter, DDS, PA
- Organization subpart
- No
- Enumeration date
- May 1, 2006
- Last updated
- Aug 22, 2020
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | – | – | Yes |
Practice location
3031 Lyndhurst AveWinston-Salem, NC 27103-4007
Phone 336-765-9154 · Fax 336-765-9291
Mailing address
3031 Lyndhurst AveWinston-Salem, NC 27103-4007
Phone 336-765-9154 · Fax 336-765-9291
Authorized official
Royce Anthony Porter
Dentist/President
3367659154
Is something wrong?
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