NPIMap

Organization Active NPI

Kim Pryzgoda DDS PA

  • Dentist
  • Fayetteville, NC
National Provider Identifier
1598833451
Registry record updated Feb 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6373 Issued in NC
Legal business name
KIM PRYZGODA DDS PA
Practice address
653 Hay Street
Fayetteville, NC 28301
Phone
(910) 826-8900
Fax
(910) 826-2244
NPI assigned
Nov 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2025

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

Authorized official

Name
Dr. Kimberly Wilson Pryzgoda, DDSNPI 1699843557
Title
Owner Dentist
Phone
(910) 826-8900

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
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 6373 NC Primary

Addresses

Primary practice location

653 Hay Street
Fayetteville, NC 28301

Mailing address

653 Hay Street
Fayetteville, NC 28301
Phone (910) 826-8900

National Provider Directory

National Provider Directory

Locations

653 Hay St
Fayetteville, NC 28301
Phone (910) 826-8900

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": "1164844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740700800000",
    "number": "1598833451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "653 HAY STREET",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "28301",
            "telephone_number": "910-826-8900",
            "fax_number": "910-826-2244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "653 HAY STREET",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "28301",
            "telephone_number": "910-826-8900",
            "fax_number": "910-826-2244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIM PRYZGODA DDS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-30",
        "last_updated": "2025-02-28",
        "certification_date": "2025-02-28",
        "status": "A",
        "authorized_official_last_name": "PRYZGODA",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "WILSON",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "910-826-8900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NC",
            "license": "6373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 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.