Provider Demographics
NPI:1508392358
Name:MICHAEL K. BIELINSKI DDS FAMILY & COSMETIC DENTISTRY
Entity Type:Organization
Organization Name:MICHAEL K. BIELINSKI DDS FAMILY & COSMETIC DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:JOHNETTE
Authorized Official - Middle Name:BRANTLEY
Authorized Official - Last Name:HARGIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-467-7360
Mailing Address - Street 1:101 SW CARY PKWY STE 60
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-7728
Mailing Address - Country:US
Mailing Address - Phone:919-467-7360
Mailing Address - Fax:
Practice Address - Street 1:101 SW CARY PKWY STE 60
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-7728
Practice Address - Country:US
Practice Address - Phone:919-467-7360
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6422122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1356452197OtherINDIVIDUAL NPI #