Individual provider Active NPI

Preston Garrett Hines, DMD

  • Dentist
  • Boone, NC
National Provider Identifier
1336868405
Registry record updated Feb 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12867 Issued in NC
Practice address
717 Greenway Rd Ste D
Boone, NC 28607-4991
Phone
(828) 264-2381
NPI assigned
Aug 23, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 12867 NC Primary

Addresses

Primary practice location

717 Greenway Rd Ste D
Boone, NC 28607-4991

Mailing address

347 Puddingstone Pkwy
Banner Elk, NC 28604-7303

Other practice location 1

108 Doctors Dr
Boone, NC 28607-5000
Phone (828) 262-3886

Other practice location 2

504 Pineola St
Newland, NC 28657-7604
Phone (828) 742-1018

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
12867NCMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1661212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677024000000",
    "number": "1336868405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "347 PUDDINGSTONE PKWY",
            "city": "BANNER ELK",
            "state": "NC",
            "postal_code": "286047303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 GREENWAY RD STE D",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "286074991",
            "telephone_number": "828-264-2381"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "108 Doctors Dr",
            "address_purpose": "LOCATION",
            "city": "Boone",
            "state": "NC",
            "postal_code": "286075000",
            "country_code": "US",
            "telephone_number": "828-262-3886",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "504 Pineola St",
            "address_purpose": "LOCATION",
            "city": "Newland",
            "state": "NC",
            "postal_code": "286577604",
            "country_code": "US",
            "telephone_number": "828-742-1018",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HINES",
        "first_name": "PRESTON",
        "middle_name": "GARRETT",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-23",
        "last_updated": "2023-02-22",
        "certification_date": "2023-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "12867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boone, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2023; 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.