Individual provider Active NPI

Kimberly Pinyan, DMD

  • Dentist
  • Winston Salem, NC
National Provider Identifier
1588080469
Registry record updated Mar 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6862 Issued in NC
Practice address
4712 Country Club Rd Ste C
Winston Salem, NC 27104-3749
Phone
(336) 760-2011
Fax
(336) 760-2847
NPI assigned
Mar 14, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 6862 NC Primary

Addresses

Primary practice location

4712 Country Club Rd Ste C
Winston Salem, NC 27104-3749

Mailing address

4712 Country Club Rd Ste C
Winston Salem, NC 27104-3749
Phone (336) 760-2011

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151211002246 NC Order and Referring Only - DentistPractitioner - Dentist 0244531440

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6862NCMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Kimberly S. Pinyan, DMD, PA Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1394755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394755200000",
    "number": "1588080469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4712 COUNTRY CLUB RD STE C",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271043749",
            "telephone_number": "336-760-2011",
            "fax_number": "336-760-2847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4712 COUNTRY CLUB RD STE C",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271043749",
            "telephone_number": "336-760-2011",
            "fax_number": "336-760-2847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PINYAN",
        "first_name": "KIMBERLY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-14",
        "last_updated": "2014-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "6862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.