Provider Demographics
NPI:1346956745
Name:INGEBORG J. DE KOK, DDS, MS, PLLC
Entity Type:Organization
Organization Name:INGEBORG J. DE KOK, DDS, MS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/PROSTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:INGEBORG
Authorized Official - Middle Name:JOHANNA
Authorized Official - Last Name:DE KOK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS MS
Authorized Official - Phone:919-387-4775
Mailing Address - Street 1:500 W WILLIAMS ST
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27502-1846
Mailing Address - Country:US
Mailing Address - Phone:919-387-4775
Mailing Address - Fax:
Practice Address - Street 1:500 W WILLIAMS ST
Practice Address - Street 2:
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27502-1846
Practice Address - Country:US
Practice Address - Phone:919-387-4775
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-30
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental