Basic Information
| Provider Information | |||||||||
| NPI: | 1841264520 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BIBERICA | ||||||||
| FirstName: | JOYCE | ||||||||
| MiddleName: | DENISE | ||||||||
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| Credential: | DMD | ||||||||
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| Mailing Information | |||||||||
| Address1: | CHEROKEE INDIAN HOSPITAL | ||||||||
| Address2: | 1 HOSPITAL ROAD | ||||||||
| City: | CHEROKEE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 28719 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8284979163 | ||||||||
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| Practice Location | |||||||||
| Address1: | CHEROKEE INDIAN HOSPITAL | ||||||||
| Address2: | 1 HOSPITAL ROAD | ||||||||
| City: | CHEROKEE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 28719 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8284979163 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/17/2006 | ||||||||
| LastUpdateDate: | 04/29/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1223G0001X | 8125 | NC | N | Dental Providers | Dentist | General Practice | 1223P0221X | 8125 | NC | Y | Dental Providers | Dentist | Pediatric Dentistry |
ID Information
| ID | Type | State | Issuer | Description | 5904310 | 05 | NC | MEDICAID |