Jack D. King, DDS, PA

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

5157 Issued in NC

Legal business name

JACK D. KING, DDS, PA

Practice address

1706 Davie Ave
Suite B
Statesville, NC 28677-3589

Phone

(704) 873-1968

Fax

(704) 872-5841

NPI assigned

Feb 16, 2012

Last updated

Feb 16, 2012By 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. Jack Douglas King, DDSNPI 1811992332

Title

President

Phone

(704) 873-1968

Specialties & licenses 1

Addresses

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.

• Jack Douglas King, DDS

  • General Practice Dentistry
  • Statesville, NC
  • NPI 1811992332
  Authorized official Same address or phone

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

{
    "created_epoch": "1329350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329350400000",
    "number": "1407129877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1706 DAVIE AVE",
            "address_2": "SUITE B",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286773589",
            "telephone_number": "704-873-1968",
            "fax_number": "704-872-5841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1706 DAVIE AVE",
            "address_2": "SUITE B",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286773589",
            "telephone_number": "704-873-1968",
            "fax_number": "704-872-5841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACK D. KING, DDS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-16",
        "last_updated": "2012-02-16",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "DOUGLAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "704-873-1968",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NC",
            "license": "5157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Iredell-Statesville Schools
• Daniela Getuza Isfan, M.D.
• Jarrett Isler
• Andrea Evbu Iyekepolo
• J&B Courier Servies LLC
• James a Vacca DDS Msco PA
• James a. Smith MD Pediatrics
• James M. Rhyne, MD,PA
• Marcia James, C.N.M.
• Janus RX

• Dental Clinic/Center in Statesville, NC
• Providers in Statesville, NC by specialty
• Dental Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2012; 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.