Healthcare Provider Details

I. General information

NPI: 1447753918
Provider Name (Legal Business Name): JULIUS M. KIOKO JR. DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2018
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7748 CHARLOTTE HWY
INDIAN LAND SC
29707-9654
US

IV. Provider business mailing address

PO BOX 208
JEFFERSON NC
28640-0208
US

V. Phone/Fax

Practice location:
  • Phone: 803-991-4361
  • Fax:
Mailing address:
  • Phone: 336-246-9449
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number13554
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number11459
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: