Provider Demographics
NPI:1023818705
Name:K. JASINSKI, D.M.D., P.C.
Entity type:Organization
Organization Name:K. JASINSKI, D.M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:HILLARY
Authorized Official - Middle Name:
Authorized Official - Last Name:THULL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-540-8946
Mailing Address - Street 1:12071 CLAYTON BLVD
Mailing Address - Street 2:STE 102
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27520-2398
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12071 CLAYTON BLVD
Practice Address - Street 2:STE 102
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27520-2398
Practice Address - Country:US
Practice Address - Phone:984-310-0020
Practice Address - Fax:984-310-0021
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:K. JASINSKI, D.M.D., P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-03-13
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty