Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Thane C. Hisaw, DMD, PA

Organization Pediatric Dentistry · NPI 1376983213

Thane C. Hisaw, DMD, PA is a Pediatric Dentistry in Greensboro, North Carolina. Licensed in North Carolina. Registered with an NPI since 2013.

Licensed in
NC
In the registry since
2013
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

504 E Cornwallis Dr Ste J
Greensboro, NC 27405-5679
Phone: (336) 378-1421
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Dentistry (primary) Taxonomy 1223P0221X · Licence 9508 (NC)

Record details

NPI number1376983213
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Thane Hisaw — President · (907) 315-6812
NPI enumeratedJune 25, 2013
Last updated in NPPESJune 27, 2013
Mailing address504 E Cornwallis Dr, Ste. J, Greensboro, NC 27405-5679

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