NPIMap

Organization Active NPI

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

Doing business as Cannon Crossroads Dental Care

  • General Practice Dentistry
  • Concord, NC
National Provider Identifier
1245820828
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
Cannon Crossroads Dental Care
Practice address
9685 Harris Rd
Concord, NC 28027-3510
Phone
(704) 490-4594
NPI assigned
Jan 19, 2021
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
Celia Hayes
Title
Credentialing Coordinator
Phone
(217) 540-5100

Specialties & licenses 1

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

Addresses

Primary practice location

9685 Harris Rd
Concord, NC 28027-3510

Mailing address

9685 Harris Rd
Concord, NC 28027-3510

Other names 1

  • Cannon Crossroads Dental Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
S Gibree DMD PC81 organizations share this tax ID, including this one
Part of
S Gibree 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

9685 Harris Rd
Concord, NC 28027
Phone (704) 490-4594

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": "1611014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728000000000",
    "number": "1245820828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9685 HARRIS RD",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280273510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9685 HARRIS RD",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280273510",
            "telephone_number": "704-490-4594"
        }
    ],
    "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": "2021-01-19",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A",
        "authorized_official_last_name": "HAYES",
        "authorized_official_first_name": "CELIA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-5100"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cannon Crossroads Dental Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Cannon Crossroads Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Concord, 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.