MEDICARE: K. JASINSKI, D.M.D., P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1982234357
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	K. JASINSKI, D.M.D., P.C.

Provider Business Mailing Address
First Line	:	8680 RACHEL FREEMAN WAY STE A
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28278-9567
Country	:	US
Telephone Number	:	980-270-6511
Fax Number	:

Provider Business Practice Location Address
First Line	:	8680 RACHEL FREEMAN WAY STE A
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28278-9567
Country	:	US
Telephone Number	:	980-270-6511
Fax Number	:	980-321-7061

Authorized Official
Title or Position	:	CREDENTIALING COORDINATOR
Name	:	JESSICA BRITT
Credential	:
Telephone Number	:	217-540-5100

Provider Enumeration Date	:	01/24/2020
Last Update Date	:	10/04/2024

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