Kimberly Wilson Pryzgoda, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

NC6373 Issued in NC

Practice address

653 Hay Street
Fayetteville, NC 28301-5433

Phone

(910) 826-8900

Fax

(910) 826-2244

NPI assigned

Nov 30, 2006

Sex

Female

Sole proprietor

Yes

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

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Kim Pryzgoda DDS PA

  • Dentist
  • Fayetteville, NC
  • NPI 1598833451
  NPD Authorized official

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737504000000",
    "number": "1699843557",
    "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": "283015466",
            "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": "283015433",
            "telephone_number": "910-826-8900",
            "fax_number": "910-826-2244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRYZGODA",
        "first_name": "KIMBERLY",
        "middle_name": "WILSON",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-30",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "NC6373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michele T Provost, PA
• Renee Mechelle Prows, LPCA
• Jackson Thomas Pruett, PT, DPT
• Lysiane Pruitt, FNP
• Pruitthealth Hospice, Inc. (PruittHealth Hospice - Fayetteville)
• Publix North Carolina LP (Publix Pharmacy #2101)
• Publix North Carolina LP
• Tiffany Vick Puckett, LCSW
• Christine Pufnock, M.S., OTR L
• Ciprian Mihail Pufulete, CPED

• Dentist in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Dentist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.