MEDICARE: K. JASINSKI, D.M.D., P.C.

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

General Provider Information

NPI Number	:	1447951611
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	K. JASINSKI, D.M.D., P.C.

Provider Business Mailing Address
First Line	:	7180 NC 73 HWY
Second Line	:
City	:	DENVER
State	:	NC
Zip	:	28037-9186
Country	:	US
Telephone Number	:	980-375-1290
Fax Number	:	980-375-1289

Provider Business Practice Location Address
First Line	:	7180 NC 73 HWY
Second Line	:
City	:	DENVER
State	:	NC
Zip	:	28037-9186
Country	:	US
Telephone Number	:	980-375-1290
Fax Number	:	980-375-1289

Authorized Official
Title or Position	:	CREDENTIALING COORDINATOR
Name	:	BELINDA HUERTA
Credential	:
Telephone Number	:	217-540-2100

Provider Enumeration Date	:	03/15/2023
Last Update Date	:	10/04/2024

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