Provider Demographics
NPI:1841055530
Name:K. JASINSKI, D.M.D., P.C.
Entity type:Organization
Organization Name:K. JASINSKI, D.M.D., P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:CEMYIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCDOUGAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-764-8609
Mailing Address - Street 1:202 BALLENTRAE CT
Mailing Address - Street 2:
Mailing Address - City:PITTSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27312-5538
Mailing Address - Country:US
Mailing Address - Phone:984-282-2225
Mailing Address - Fax:984-282-2139
Practice Address - Street 1:202 BALLENTRAE CT
Practice Address - Street 2:
Practice Address - City:PITTSBORO
Practice Address - State:NC
Practice Address - Zip Code:27312-5538
Practice Address - Country:US
Practice Address - Phone:984-282-2225
Practice Address - Fax:984-282-2139
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:K. JASINSKI, D.M.D., P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-02-21
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty