Provider Demographics
NPI:1538350640
Name:PAYNICH, JOSHUA D (DDS)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:D
Last Name:PAYNICH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 YORKSHIRE ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-2751
Mailing Address - Country:US
Mailing Address - Phone:828-274-4744
Mailing Address - Fax:828-274-4220
Practice Address - Street 1:11 YORKSHIRE ST
Practice Address - Street 2:SOUTE C
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-2751
Practice Address - Country:US
Practice Address - Phone:828-274-4744
Practice Address - Fax:828-274-4220
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-05
Last Update Date:2007-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7473122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
902HXOtherBCBS NC
NC89902HXMedicaid