Organization Active NPI

Jyotimallika, D.M.D., P.L.L.C.

  • General Practice Dentistry
  • Henderson, NC
National Provider Identifier
1376429043
Registry record updated Aug 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
JYOTIMALLIKA, D.M.D., P.L.L.C.
Practice address
568 Ruin Creek Rd Ste 127
Henderson, NC 27536-2881
Phone
(252) 430-7110
NPI assigned
Aug 15, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2025

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

Authorized official

Name
Ashish SinghNPI 1083611149
Title
Manager
Phone
(252) 767-9619

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

568 Ruin Creek Rd Ste 127
Henderson, NC 27536-2881

Mailing address

568 Ruin Creek Rd Ste 127
Henderson, NC 27536-2881

National Provider Directory

National Provider Directory

Locations

568 Ruin Creek Rd
Ste 127
Henderson, NC 27536
Phone (252) 430-7110

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1755216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755993600000",
    "number": "1376429043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "568 RUIN CREEK RD STE 127",
            "city": "HENDERSON",
            "state": "NC",
            "postal_code": "275362881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "568 RUIN CREEK RD STE 127",
            "city": "HENDERSON",
            "state": "NC",
            "postal_code": "275362881",
            "telephone_number": "252-430-7110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JYOTIMALLIKA, D.M.D., P.L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-15",
        "last_updated": "2025-08-24",
        "certification_date": "2025-08-22",
        "status": "A",
        "authorized_official_last_name": "SINGH",
        "authorized_official_first_name": "ASHISH",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "252-767-9619"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2025; 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.