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PHYSIOLOGIC AESTHETICS
NPI 1053779538
Durable Medical Equipment & Medical Supplies - Customized Equipment in Raleigh, NC

Active since January 29, 2016
5904 SIX FORKS RD, SUITE 225, RALEIGH, NC 27609(919) 782-9955 Get Directions Write a Review

NPPES record last updated: January 29, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Physiologic Aesthetics NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PHYSIOLOGIC AESTHETICS (NPI 1053779538) is a healthcare organization registered as a customized equipment in Raleigh, North Carolina and active in the NPI registry since January 2016. The organization lists Tracy L Davidian, Dentist/owner, as its authorized official.

NPPES Registry Identity

NPI1053779538
Entity TypeOrganization
Primary Taxonomy332BC3200X
Legal Business NameTRACY L DAVIDIAN DDS PA
Location Address5904 SIX FORKS RD, SUITE 225Raleigh, NC 27609-3838
Mailing Address5904 Six Forks Rd, Suite 225Raleigh, NC 27609-3838 · (919) 782-9955
Phone(919) 782-9955
Organization SubpartNo
Authorized OfficialTracy L DavidianDentist/owner · (919) 782-9955
Enumeration DateJanuary 29, 2016
✔ NPI 1053779538 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDurable Medical Equipment & Medical Supplies · Customized EquipmentSuppliers
Taxonomy Code332BC3200X
License✔ Licensed in NC · 7149
5904 SIX FORKS RD, Raleigh, NC 27609
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Other Names 1

Doing Business AsPhysiologic Aesthetics

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. VIRGINIA SCHREINER MD
Pediatrics
5904 SIX FORKS RD, SUITE 111
RALEIGH, NC 27609
Wake County (919) 787-9555
GEORGETTE FERNANDA GURA CPNP
Nurse Practitioner (Pediatrics)
5904 SIX FORKS RD, STE 111
RALEIGH, NC 27609
Wake County (919) 787-9555
HEATHER STARR MILLER RN,BSN,IBCLC
Registered Nurse (Lactation Consultant)
5904 SIX FORKS RD, SUITE 111
RALEIGH, NC 27609
Wake County (919) 787-9555
DR. CAMERON FRANK CAVOLA D.M.D., M.D.
Dentist (Oral and Maxillofacial Surgery)
5904 SIX FORKS RD, STE 101
RALEIGH, NC 27609
Wake County (919) 322-4500

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tracy L Davidian Dds PA's NPI number?

The NPI number for Tracy L Davidian Dds PA is 1053779538. It was assigned to this organization in the NPPES registry on January 29, 2016. The provider is doing business as Physiologic Aesthetics.

Where is Tracy L Davidian Dds PA located?

Tracy L Davidian Dds PA is located at 5904 Six Forks Rd Suite 225, Raleigh, NC 27609. The listed phone number is (919) 782-9955.

What is Tracy L Davidian Dds PA's specialty?

The primary specialty registered for this NPI is Durable Medical Equipment & Medical Supplies, specializing in Customized Equipment, with taxonomy code 332BC3200X.

When was this NPI record last updated?

The NPPES record for Tracy L Davidian Dds PA was last updated on January 29, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.