Kurt a. McKissick, DDS, PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4668 Issued in NC

Legal business name

KURT A. MCKISSICK, DDS, PA

Practice address

107 Edinburgh South Dr Ste 200
Cary, NC 27511-6454

Phone

(919) 481-3007

Fax

(919) 481-6637

NPI assigned

May 8, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Kurt A. McKissick, DDSNPI 1205924131

Title

President

Phone

(919) 481-3007

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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.

• Kurt Alan McKissick, D.D.S.

  • General Practice Dentistry
  • Cary, NC
  • NPI 1205924131
  NPD (past) Authorized official

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1285847012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 EDINBURGH SOUTH DR STE 200",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275116454",
            "telephone_number": "919-481-3007",
            "fax_number": "919-481-6637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 EDINBURGH SOUTH DR STE 200",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275116454",
            "telephone_number": "919-481-3007",
            "fax_number": "919-481-6637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KURT A. MCKISSICK, DDS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCKISSICK",
        "authorized_official_first_name": "KURT",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "919-481-3007",
        "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": "4668",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE #",
            "identifier": "4668",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amit Kumar, M.D.
• Sindhura Kunaparaju
• Donna Kuni
• Christina Anastasia Kunycky, MD
• Kure Pharmacy
• Kurt G Vernon MD PA
• Yee Ling Kwan, RN, CRNA
• Yongjin Kwon
• Concetta La Gatta, LMT
• Laboratory Corporation of America Holdings

• General Practice Dentistry in Cary, NC
• Providers in Cary, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.