Jeffrey E Aycock, DMD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

11191 Issued in NC

Practice address

131 Miller St
Winston Salem, NC 27103-2508

Phone

(336) 716-8200

NPI assigned

Aug 4, 2009

Last updated

Aug 23, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Mar 5, 2025 through Mar 5, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Coastal Carolina Cosmetic Facial Surgery

  • Oral and Maxillofacial Surgery Clinic/Center
  • Myrtle Beach, SC
  • NPI 1972081941
  NPD (past)
• Coastal Carolina Oral Maxillofacial Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Myrtle Beach, SC
  • NPI 1194812339
  NPD (past)

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

{
    "created_epoch": "1249344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661212800000",
    "number": "1568693877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 MCKENZIE CIR",
            "city": "SOUTHPORT",
            "state": "NC",
            "postal_code": "284615192",
            "telephone_number": "985-226-7667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 MILLER ST",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271032508",
            "telephone_number": "336-716-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AYCOCK",
        "first_name": "JEFFREY",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-04",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NC",
            "license": "11191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laraib Awan
• Aware Physical Therapy,LLC
• Henry Awopetu
• Anastasia Axiopoulou, MD
• Daniel Oluwaseun Ayanga, M.D.,M.P.H.
• Lashonda Ann Aycock, LCSW
• Derek Ayers, D.O.
• Kathleen Ayers
• Harry Lee Aylor Jr., D.D.S.
• Amy Ayres

• Oral and Maxillofacial Surgery (Dentist) in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Oral and Maxillofacial Surgery (Dentist) in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.