Healthcare Provider Details

I. General information

NPI: 1891650875
Provider Name (Legal Business Name): KEVIN MANCINI DMD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2025
Last Update Date: 12/22/2025
Certification Date: 12/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

61 N HAMPSTEAD VILLAGE DR
HAMPSTEAD NC
28443-3932
US

IV. Provider business mailing address

61 N HAMPSTEAD VILLAGE DR
HAMPSTEAD NC
28443-3932
US

V. Phone/Fax

Practice location:
  • Phone: 910-270-3334
  • Fax:
Mailing address:
  • Phone: 910-270-3334
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: ALEXIS BERNAL
Title or Position: QUALITY ASSURANCE SPECIALIST
Credential:
Phone: 972-869-3789