Organization Active NPI

K. Jasinski, D.M.D., P.C.

Doing business as Riverbend Village Dental Care

  • General Practice Dentistry
  • Charlotte, NC
National Provider Identifier
1093354854
Registry record updated Oct 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
K. JASINSKI, D.M.D., P.C.
Doing business as
Riverbend Village Dental Care
Practice address
9511 Riverbend Village Dr Ste I5
Charlotte, NC 28216-9124
Phone
(704) 697-5908
Fax
(980) 237-9748
NPI assigned
Dec 27, 2019
Last updated
Oct 4, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
K. JASINSKI, D.M.D., P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 4, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jessica Britt
Title
Credentialing Coordinator
Phone
(217) 540-5100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

9511 Riverbend Village Dr Ste I5
Charlotte, NC 28216-9124

Mailing address

9511 Riverbend Village Dr Ste I5
Charlotte, NC 28216-9124
Phone (109) 335-4854

Other names 1

  • Riverbend Village Dental Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
K Jasinski DMD PC81 organizations share this tax ID, including this one
Part of
K Jasinski DMD PC

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

9511 Riverbend Village Dr
Ste I5
Charlotte, NC 28216
Phone (704) 697-5908

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1577404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728000000000",
    "number": "1093354854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9511 RIVERBEND VILLAGE DR STE I5",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282169124",
            "telephone_number": "109-335-4854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9511 RIVERBEND VILLAGE DR STE I5",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282169124",
            "telephone_number": "704-697-5908",
            "fax_number": "980-237-9748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "K. JASINSKI, D.M.D., P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "K. JASINSKI, D.M.D., P.C.",
        "enumeration_date": "2019-12-27",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A",
        "authorized_official_last_name": "BRITT",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-5100"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Riverbend Village Dental Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Riverbend Village Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.