Healthcare Provider Details

I. General information

NPI: 1326200023
Provider Name (Legal Business Name): KIMBERLY TOMASHESKI D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2008
Last Update Date: 02/01/2024
Certification Date: 02/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1586 TICE HURST LN
APEX NC
27502-6500
US

IV. Provider business mailing address

1586 TICE HURST LN
APEX NC
27502-6500
US

V. Phone/Fax

Practice location:
  • Phone: 919-260-4086
  • Fax:
Mailing address:
  • Phone: 919-260-4086
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number8617
License Number StateNC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: