Individual provider Active NPI

Precious Boston, DMD

  • General Practice Dentistry
  • Charlotte, NC
National Provider Identifier
1265051783
Registry record updated Aug 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12054 Issued in NC
Practice address
8680 Rachel Freeman Way Ste a
Charlotte, NC 28278-9567
Phone
(980) 270-6511
NPI assigned
Apr 14, 2020
Last updated
Aug 30, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
General Practice Dentistry 1223G0001X 12054 NC Primary

Addresses

Primary practice location

8680 Rachel Freeman Way Ste a
Charlotte, NC 28278-9567

Mailing address

8680 Rachel Freeman Way Ste a
Charlotte, NC 28278-9567

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200520001074 TN Order and Referring Only - DentistPractitioner - Dentist 2062843378

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12054NCMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
K. Jasinski, D.M.D., P.C. General Practice CurrentSince Sep 5, 2021 Accepting new patients

Locations

8680 Rachel Freeman Way
#A
Charlotte, NC 28278
Phone (980) 270-6511

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1586822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630281600000",
    "number": "1265051783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8680 RACHEL FREEMAN WAY STE A",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282789567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8680 RACHEL FREEMAN WAY STE A",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282789567",
            "telephone_number": "980-270-6511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSTON",
        "first_name": "PRECIOUS",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-14",
        "last_updated": "2021-08-30",
        "certification_date": "2021-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "12054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.