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	:	1922952688
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	K. JASINSKI, D.M.D., P.C.

Provider Business Mailing Address
First Line	:	151 PARKVIEW CENTER CIR
Second Line	:
City	:	CLAYTON
State	:	NC
Zip	:	27520-1788
Country	:	US
Telephone Number	:	984-989-6131
Fax Number	:	984-989-6063

Provider Business Practice Location Address
First Line	:	151 PARKVIEW CENTER CIR
Second Line	:
City	:	CLAYTON
State	:	NC
Zip	:	27520-1788
Country	:	US
Telephone Number	:	984-989-6131
Fax Number	:	984-989-6063

Authorized Official
Title or Position	:	CREDENTIALING COORDINATOR
Name	:	HILLARY THULL
Credential	:
Telephone Number	:	217-540-8946

Provider Enumeration Date	:	02/20/2026
Last Update Date	:	02/20/2026

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