Charles J King, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS-022138-L Issued in PA

Practice address

2534 Willow Street Pike N
Willow Street, PA 17584-9585

Phone

(717) 464-5534

NPI assigned

Apr 18, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432598400000",
    "number": "1316163074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2534 WILLOW STREET PIKE N",
            "city": "WILLOW STREET",
            "state": "PA",
            "postal_code": "175849585",
            "telephone_number": "717-464-5534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2534 WILLOW STREET PIKE N",
            "city": "WILLOW STREET",
            "state": "PA",
            "postal_code": "175849585",
            "telephone_number": "717-464-5534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "CHARLES",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-18",
        "last_updated": "2015-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS-022138-L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Lynn Irons, CRNP
• Alisia Ives, LPC
• Rushita Javia
• Kent V. Flinchbaugh DPM LTD.
• Ann M King, M.D.
• Philip Muigai Kirumba
• Laura J Kline, O.T.
• Jennifer Nicole Knight, DPT
• Shawnda L Koser, MSPT
• Tiffany Margaret Kress

• General Practice Dentistry in Willow Street, PA
• Providers in Willow Street, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.