NPIMap

Organization Active NPI

Joey D Pesicek

  • General Practice Dentistry
  • Kinston, NC
National Provider Identifier
1164697108
Registry record updated Apr 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7647 Issued in NC
Legal business name
JOEY D PESICEK
Practice address
1104 W Vernon Ave
Kinston, NC 28501-3616
Phone
(252) 523-4151
Fax
(252) 527-0738
NPI assigned
Apr 29, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2008

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

Authorized official

Name
Dr. Joey D Pesick, DDS
Title
Owner
Phone
(252) 523-4151

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 7647 NC Primary

Addresses

Primary practice location

1104 W Vernon Ave
Kinston, NC 28501-3616

Mailing address

1104 W Vernon Ave
Kinston, NC 28501-3616
Phone (252) 523-4151

Other identifiers 1

IdentifierTypeStateIssuer
902V7OtherNCBLUE CROSS AND BLUE SHIELD

Other names 1

  • kinston dental associates Doing business as

National Provider Directory

National Provider Directory

Locations

1104 W Vernon Ave
Kinston, NC 28501
Phone (252) 523-4151

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1209427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209427200000",
    "number": "1164697108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1104 W VERNON AVE",
            "city": "KINSTON",
            "state": "NC",
            "postal_code": "285013616",
            "telephone_number": "252-523-4151",
            "fax_number": "252-527-0738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1104 W VERNON AVE",
            "city": "KINSTON",
            "state": "NC",
            "postal_code": "285013616",
            "telephone_number": "252-523-4151",
            "fax_number": "252-527-0738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOEY D PESICEK",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-29",
        "last_updated": "2008-04-29",
        "status": "A",
        "authorized_official_last_name": "PESICK",
        "authorized_official_first_name": "JOEY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "252-523-4151",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "7647",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS AND BLUE SHIELD",
            "identifier": "902V7",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "kinston dental associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kinston, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2008; 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.