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General NPI Number Information
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NPI Number | 1649964008
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Entity Type | Organization
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Legal Business Name | K. JASINSKI, D.M.D., P.C.
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Dates
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Enumeration Date | 06/07/2023
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Last Update Date | 10/04/2024
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Provider Practice Location Address
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Address Line | 14013 N CREEK VILLAGE DR STE 100
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City | HUNTERSVILLE
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State | NC
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Zip | 28078-4018
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Country | US
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Telephone | 980-306-2150
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Fax | 980-306-2157
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Provider Business Mailing Address
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Address Line | 14013 N CREEK VILLAGE DR STE 100
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City | HUNTERSVILLE
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State | NC
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Zip | 28078-4018
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Country | US
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Telephone | 980-306-2150
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Fax | 980-306-2157
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Authorized Official
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Title or Position | CREDENTIALING COORDINATOR
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Name | BELINDA HUERTA
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Credential |
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Telephone | 217-540-2100
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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 |
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