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SOUTHPARK PERIODONTICS
NPI 1225582596
Dentist - Periodontics in Charlotte, NC

Active since August 04, 2016
6719 FAIRVIEW RD, CHARLOTTE, NC 28210(704) 366-2774(704) 366-2639 Get Directions Write a Review

NPPES record last updated: July 21, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Southpark Periodontics NPPES

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

SOUTHPARK PERIODONTICS (NPI 1225582596) is a healthcare organization registered as a periodontics in Charlotte, North Carolina and active in the NPI registry since August 2016. The organization lists Bobby L Cockerham, Owner, as its authorized official.

NPPES Registry Identity

NPI1225582596
Entity TypeOrganization
Primary Taxonomy1223P0300X
Legal Business NameB.L. COCKERHAM III & ASSOCIATES PLLC
Location Address6719 FAIRVIEW RDCharlotte, NC 28210-3879
Mailing Address6719 Fairview RdCharlotte, NC 28210-3879 · (704) 366-2774 · Fax (704) 366-2639
Phone(704) 366-2774
Fax(704) 366-2639
Organization SubpartNo
Authorized OfficialBobby L CockerhamOwner · (704) 366-2774
Enumeration DateAugust 4, 2016
Last NPPES UpdateJuly 21, 2023
NPPES CertifiedJuly 21, 2023
✔ NPI 1225582596 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · PeriodonticsDental Providers
Taxonomy Code1223P0300X
Licenses✔ Licensed in NC · 9124✔ Licensed in NC · 4673
Definition
That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.
6719 FAIRVIEW RD, Charlotte, NC 28210
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Other Names 1

Doing Business AsSouthpark Periodontics

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC.Insurance ›

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. RICHARD E OFFUTT III DDS
Dentist (Periodontics)
6719 FAIRVIEW RD
CHARLOTTE, NC 28210
Mecklenburg County (704) 366-2774
RICHARD E. OFFUTT, DDS, PA
Dentist (Periodontics)
6719 FAIRVIEW RD
CHARLOTTE, NC 28210
Mecklenburg County (704) 366-2774
ASHLEY ALEXANDRA PATER
Dentist (Periodontics)
6719 FAIRVIEW RD
CHARLOTTE, NC 28210
Mecklenburg County (704) 366-2774
DR. BOBBY LEE COCKERHAM III D.D.S, M.S.D
Dentist (Periodontics)
6719 FAIRVIEW RD
CHARLOTTE, NC 28210
Mecklenburg County (704) 366-2774

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 B.L. Cockerham III & Associates PLLC's NPI number?

The NPI number for B.L. Cockerham III & Associates PLLC is 1225582596. It was assigned to this organization in the NPPES registry on August 4, 2016. The provider is doing business as Southpark Periodontics.

Where is B.L. Cockerham III & Associates PLLC located?

B.L. Cockerham III & Associates PLLC is located at 6719 Fairview Rd, Charlotte, NC 28210. The listed phone number is (704) 366-2774.

What is B.L. Cockerham III & Associates PLLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

What insurance does B.L. Cockerham III & Associates PLLC accept?

Health plans from Blue Cross and Blue Shield of NC list B.L. Cockerham III & Associates PLLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for B.L. Cockerham III & Associates PLLC was last updated on July 21, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.