GANGLANI WAKE FOREST PLLC
NPI 1255177705
Dentist - General Practice in Wake Forest, NC

Q: What is Ganglani Wake Forest PLLC's NPI number?

The NPI number for Ganglani Wake Forest PLLC is 1255177705. It was assigned to this organization in the NPPES registry on July 3, 2024. The provider is doing business as Supremia Dentistry.

Q: What is Ganglani Wake Forest PLLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Active since July 03, 2024

1704 S MAIN ST # 110, WAKE FOREST, NC 27587(919) 556-6200 Get Directions Write a Review

NPPES record last updated: July 3, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Ganglani Wake Forest Pllc NPPES

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

GANGLANI WAKE FOREST PLLC (NPI 1255177705), doing business as Supremia Dentistry, is a healthcare organization registered as a general practice in Wake Forest, North Carolina and active in the NPI registry since July 2024. The organization lists Chad Hendricks, Credentialing, as its authorized official.

NPPES Registry Identity

NPI1255177705

Entity TypeOrganization

Primary Taxonomy1223G0001X

Legal Business NameGANGLANI WAKE FOREST PLLC

Location Address1704 S MAIN ST # 110Wake Forest, NC 27587-7323

Mailing Address1704 S Main St # 110Wake Forest, NC 27587-7323 · (919) 556-6200

Phone(919) 556-6200

Organization SubpartNo

Authorized OfficialChad HendricksCredentialing · (612) 859-0444

Enumeration DateJuly 3, 2024

NPPES CertifiedJuly 3, 2024

✔ NPI 1255177705 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

Definition

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

1704 S MAIN ST # 110, Wake Forest, NC 27587

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Other Names 1

Doing Business AsSupremia Dentistry

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

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 Ganglani Wake Forest PLLC's NPI number?

The NPI number for Ganglani Wake Forest PLLC is 1255177705. It was assigned to this organization in the NPPES registry on July 3, 2024. The provider is doing business as Supremia Dentistry.

Where is Ganglani Wake Forest PLLC located?

Ganglani Wake Forest PLLC is located at 1704 S Main St # 110, Wake Forest, NC 27587. The listed phone number is (919) 556-6200.

What is Ganglani Wake Forest PLLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for Ganglani Wake Forest PLLC was last updated on July 3, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.