SOUTH PARK ORAL SURGERY
NPI 1003502519
Dentist - Oral and Maxillofacial Surgery in Charlotte, NC
NPI Status: Active since April 17, 2023
Contact Information
2719 COLTSGATE RD
CHARLOTTE, NC
ZIP 28211
Phone: (704) 366-8707
Fax: (704) 366-8717
- Organization
- Dentist
- Oral and Maxillofacial Surgery
- CLIA Number: 34D2294996
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 12-03-2027
About SOUTH PARK ORAL SURGERY
This page provides the complete NPI Profile along with additional information for South Park Oral Surgery, a provider established in Charlotte, North Carolina operating as a Dentist, focusing in oral and maxillofacial surgery . The healthcare provider is registered in the NPI registry with number 1003502519 assigned on April 2023. The practitioner's primary taxonomy code is 1223S0112X. The provider is registered as an organization and their NPI record was last updated 3 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Dr. Kevin P Bond (Dentist/owner)
- NPI
- 1003502519
- Provider Name
- SOUTH PARK ORAL SURGERY
- Entity Type
- Organization
- Location Address
- 2719 COLTSGATE RD CHARLOTTE, NC 28211
- Location Phone
- (704) 366-8707
- Location Fax
- (704) 366-8717
- Mailing Address
- 2719 COLTSGATE RD CHARLOTTE, NC 28211
- Mailing Phone
- (704) 366-8707
- Mailing Fax
- (704) 366-8717
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 04-17-2023
- Last Update Date
- 04-17-2023
- Code Navigator
A dentist like South Park Oral Surgery is a skilled in and licensed provider that diagnoses and treats problems with patients teeth, gums, and related parts of the mouth. Dentists educate patients on how to take care of the teeth and gums and provide information on diet choices that affect oral health. Dentists must be licensed in the state in which they work.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Dentist Oral and Maxillofacial Surgery
- Taxonomy Code
- 1223S0112X
- Type
- Dental Providers
- Taxonomy Description
- An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 34D2294996
- Facility Type
- Physician Office
- Certificate Effective Date
- December 04, 2025
- Certificate Expiration Date
- December 03, 2027
- Laboratory Director
- JENNIFER HONG
- Certificate Type
- Certificate for Provider-Performed Microscopy Procedures (PPMP)
- Certificate Type Description
- This CLIA certificate is issued to South Park Oral Surgery in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1003502519, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 41. The final step is to find the difference between that total and the next multiple of ten (50 - 41 = 9).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 41 is 50. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1003502519, enumerated as an "organization" on April 17, 2023.
The provider is located at 2719 COLTSGATE RD CHARLOTTE, NC 28211 and the phone number is (704) 366-8707.
Dentist with taxonomy code 1223S0112X and a focus in Oral and Maxillofacial Surgery.
