Active NPI
Mark Lendyl Naguit Trinidad
- General Practice Dentistry
- Wake Forest, NC
National Provider Identifier
1336904804
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 13997
- Practice address
- 1001 Stadium Dr.
Suite 120
Wake Forest, NC 27587 - Phone
- (919) 570-9100
- NPI assigned
- Feb 14, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| General Practice Dentistry | 1223G0001X | 13997 | NC | Primary |
Addresses
Primary practice location
1001 Stadium Dr.
Suite 120
Wake Forest, NC 27587
Mailing address
1001 Stadium Dr.
Suite 120
Wake Forest, NC 27587
Phone (919) 570-9100
Other practice location 1
635 Albany St
Boston, MA 02118-3550
Phone (617) 358-8300
Other practice location 2
1034 Yunus Rd
Suite 150
Durham, NC 27703
Phone (919) 321-0540
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
| License | State | Type | Specialty |
|---|---|---|---|
| 13997 | NC | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| K. Jasinski, D.M.D., P.C. | General Practice | Current | Accepting new patients |
| K. Jasinski, D.M.D., P.C. | General Practice | Past | Accepting new patients |
Locations
1001 Stadium Dr
Ste 120
Wake Forest, NC 27587
Phone (919) 570-9100
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Dentistry
- Wake Forest, NC
- NPI 1598424533
-
- General Practice Dentistry
- Durham, NC
- NPI 1578272159
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1707868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728432000000",
"number": "1336904804",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1001 STADIUM DR.",
"address_2": "SUITE 120",
"city": "WAKE FOREST",
"state": "NC",
"postal_code": "27587",
"telephone_number": "919-570-9100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1001 STADIUM DR.",
"address_2": "SUITE 120",
"city": "WAKE FOREST",
"state": "NC",
"postal_code": "27587",
"telephone_number": "919-570-9100"
}
],
"practiceLocations": [
{
"address_1": "635 Albany St",
"address_purpose": "LOCATION",
"city": "Boston",
"state": "MA",
"postal_code": "021183550",
"country_code": "US",
"telephone_number": "617-358-8300",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1034 Yunus Rd",
"address_2": "Suite 150",
"address_purpose": "LOCATION",
"city": "Durham",
"state": "NC",
"postal_code": "27703",
"country_code": "US",
"telephone_number": "919-321-0540",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TRINIDAD",
"first_name": "MARK LENDYL",
"middle_name": "NAGUIT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-02-14",
"last_updated": "2024-10-09",
"certification_date": "2024-10-05",
"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": "13997",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Wake Forest, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 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.