NPIMap

Organization Active NPI

Kenneth J Rasbornik, DMD PA

  • General Practice Dentistry
  • Cleveland, NC
National Provider Identifier
1194023481
Registry record updated Mar 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6374 Issued in NC
Legal business name
KENNETH J RASBORNIK, DMD PA
Practice address
11707 Statesville Blvd
Cleveland, NC 27013-9418
Phone
(704) 278-1118
Fax
(704) 278-4480
NPI assigned
Mar 10, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2011

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

Authorized official

Name
Mr. Kenneth James Rasbornik, DMD, PANPI 1326138751
Title
Owner/Doctor
Phone
(704) 278-1118

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 6374 NC Primary

Addresses

Primary practice location

11707 Statesville Blvd
Cleveland, NC 27013-9418

Mailing address

11707 Statesville Blvd
Cleveland, NC 27013-9418
Phone (704) 278-1118

National Provider Directory

National Provider Directory

Locations

11707 Statesville Blvd
Cleveland, NC 27013
Phone (704) 278-1118

Practitioners & affiliated clinicians

Practitioners 1

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": "1299715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299715200000",
    "number": "1194023481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11707 STATESVILLE BLVD",
            "city": "CLEVELAND",
            "state": "NC",
            "postal_code": "270139418",
            "telephone_number": "704-278-1118",
            "fax_number": "704-278-4480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11707 STATESVILLE BLVD",
            "city": "CLEVELAND",
            "state": "NC",
            "postal_code": "270139418",
            "telephone_number": "704-278-1118",
            "fax_number": "704-278-4480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNETH J RASBORNIK, DMD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-10",
        "last_updated": "2011-03-10",
        "status": "A",
        "authorized_official_last_name": "RASBORNIK",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "OWNER/DOCTOR",
        "authorized_official_telephone_number": "704-278-1118",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DMD, PA"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "6374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2011; 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.