Active NPI
Susan Kimberly Jones
- Pediatric Dentistry
- Hickory, NC
National Provider Identifier
1497810212
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 6049
- Practice address
- 1204 N Center Street
Hickory, NC 28601 - Phone
- (828) 327-9029
- Fax
- (828) 327-9059
- NPI assigned
- Dec 22, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 6049 | NC | Primary |
Addresses
Primary practice location
1204 N Center Street
Hickory, NC 28601
Mailing address
1204 N Center Street
Hickory, NC 28601
Phone (828) 327-9029
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8994705 | Medicaid | NC |
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 |
|---|---|---|---|
| 6049 | NC | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166745600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1497810212",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1204 N CENTER STREET",
"city": "HICKORY",
"state": "NC",
"postal_code": "28601",
"telephone_number": "828-327-9029",
"fax_number": "828-327-9059"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1204 N CENTER STREET",
"city": "HICKORY",
"state": "NC",
"postal_code": "28601",
"telephone_number": "828-327-9029",
"fax_number": "828-327-9059"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JONES",
"first_name": "SUSAN",
"middle_name": "KIMBERLY",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "NC",
"license": "6049",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8994705",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hickory, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.