Active NPI
Blake Kingsbury DMD PLLC
- General Practice Dentistry
- Gastonia, NC
National Provider Identifier
1740522333
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- Legal business name
- BLAKE KINGSBURY DMD PLLC
- Practice address
- 2557 Pembroke Rd
2557 Pembroke Rd
Gastonia, NC 28054-4712 - Phone
- (704) 854-8887
- Fax
- (704) 854-8893
- NPI assigned
- Mar 21, 2013
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Blake Carson Kingsbury, D.M.D
- Title
- Dentist
- Phone
- (704) 854-8887
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) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | Primary |
Addresses
Primary practice location
2557 Pembroke Rd
2557 Pembroke Rd
Gastonia, NC 28054-4712
Mailing address
2557 Pembroke Rd
Gastonia, NC 28054-4712
Phone (704) 854-8887
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831338276 | Other | NC | DENTAL |
Other names 1
- Godel Family Dentistry
National Provider Directory
National Provider Directory- Tax ID family
- Blake Kingsbury DMD PLLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Dentist
- Gastonia, NC
- NPI 1558733410
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- General Practice Dentistry
- Asheville, NC
- NPI 1831338276
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1363824000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1363824000000",
"number": "1740522333",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2557 PEMBROKE RD",
"city": "GASTONIA",
"state": "NC",
"postal_code": "280544712",
"telephone_number": "704-854-8887",
"fax_number": "704-854-8893"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2557 PEMBROKE RD",
"address_2": "2557 PEMBROKE RD",
"city": "GASTONIA",
"state": "NC",
"postal_code": "280544712",
"telephone_number": "704-854-8887",
"fax_number": "704-854-8893"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BLAKE KINGSBURY DMD PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2013-03-21",
"last_updated": "2013-03-21",
"status": "A",
"authorized_official_last_name": "KINGSBURY",
"authorized_official_first_name": "BLAKE",
"authorized_official_middle_name": "CARSON",
"authorized_official_title_or_position": "DENTIST",
"authorized_official_telephone_number": "704-854-8887",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "D.M.D"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist, General Practice",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTAL",
"identifier": "1831338276",
"state": "NC"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Godel Family Dentistry",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Gastonia, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.