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General NPI Number Information
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NPI Number | 1134264195
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Entity Type | Organization
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Legal Business Name | JASPER L. LEWIS, JR., D.D.S., P.A.
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Dates
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Enumeration Date | 02/20/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 1025 JOHNS HOPKINS DR
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City | GREENVILLE
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State | NC
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Zip | 27834-7227
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Country | US
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Telephone | 252-752-6188
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Fax | 252-752-5728
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Provider Business Mailing Address
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Address Line | 1025 JOHNS HOPKINS DR
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City | GREENVILLE
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State | NC
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Zip | 27834-7227
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Country | US
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Telephone | 252-752-6188
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Fax | 252-752-5728
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Authorized Official
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Title or Position | PRESIDENT
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Name | JASPER LEE LEWIS JR.
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Credential | D.D.S.
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Telephone | 252-752-6188
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State | NC
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