MEDICARE: DR. KASEY LYNN SCOTT DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	14727	NC

General Provider Information

NPI Number	:	1164111837
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KASEY LYNN SCOTT DMD

Provider Business Mailing Address
First Line	:	701 PINER RD # 160
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28409-4203
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	701 PINER RD # 160
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28409-4203
Country	:	US
Telephone Number	:	910-791-7911
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/08/2023
Last Update Date	:	06/11/2026

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