Provider Demographics
NPI:1952752479
Name:EPPS, KASEY OXENDINE (DMD)
Entity Type:Individual
Prefix:DR
First Name:KASEY
Middle Name:OXENDINE
Last Name:EPPS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:KASEY
Other - Middle Name:OXENDINE
Other - Last Name:EPPS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:60 COMMERCE PLAZA CIR
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE
Mailing Address - State:NC
Mailing Address - Zip Code:28372-7386
Mailing Address - Country:US
Mailing Address - Phone:910-740-1120
Mailing Address - Fax:910-775-9165
Practice Address - Street 1:210 S WALNUT STREET
Practice Address - Street 2:
Practice Address - City:FAIRMONT
Practice Address - State:NC
Practice Address - Zip Code:28340
Practice Address - Country:US
Practice Address - Phone:910-668-6534
Practice Address - Fax:910-668-6535
Is Sole Proprietor?:No
Enumeration Date:2016-06-27
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10428122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC10428OtherSTATE LICENSE