Provider Demographics
NPI:1871907949
Name:THROOP, VIVIAN ARIAIL (DDS)
Entity type:Individual
Prefix:DR
First Name:VIVIAN
Middle Name:ARIAIL
Last Name:THROOP
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5109 BUR OAK CIR STE 100
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-3101
Mailing Address - Country:US
Mailing Address - Phone:919-787-4915
Mailing Address - Fax:
Practice Address - Street 1:5109 BUR OAK CIR STE 100
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-3101
Practice Address - Country:US
Practice Address - Phone:919-787-4915
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-17
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC99511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice