Kong Peng Lor

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

14276 Issued in NC

Practice address

89 N Mitchell Ave
Bakersville, NC 28705-6502

Phone

(828) 537-5991

Fax

(732) 393-8492

NPI assigned

May 8, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

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

Specialty

Dentist

Education

East Carolina University School of Dentistry, 2025

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Mountain Community Health Partnership Incorporated

  • Federally Qualified Health Center (FQHC)
  • Bakersville, NC
  • NPI 1043315054
  Medicare reassignment NPD
• Mountain Community Health Partnership Incorporated

  • Physical Therapist
  • Burnsville, NC
  • NPI 1033971049
  NPD
• Mountain Community Health Partnership Incorporated

  • Federally Qualified Health Center (FQHC)
  • Bakersville, NC
  • NPI 1619517976

  General Practice

  NPD
• Mountain Community Health Partnership Incorporated

  • Federally Qualified Health Center (FQHC)
  • Burnsville, NC
  • NPI 1568914521
  NPD (past)
• Mountain Community Health Partnership Incorporated

  • Federally Qualified Health Center (FQHC)
  • Burnsville, NC
  • NPI 1831799667
  NPD (past)

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

{
    "created_epoch": "1683504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752019200000",
    "number": "1811686579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "86 N MITCHELL AVE",
            "city": "BAKERSVILLE",
            "state": "NC",
            "postal_code": "287056502",
            "telephone_number": "828-688-2104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "89 N MITCHELL AVE",
            "city": "BAKERSVILLE",
            "state": "NC",
            "postal_code": "287056502",
            "telephone_number": "828-537-5991",
            "fax_number": "732-393-8492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOR",
        "first_name": "KONG",
        "middle_name": "PENG",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-08",
        "last_updated": "2025-07-09",
        "certification_date": "2025-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "14276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacob Jarrett, MMS, PA-C
• Jordon Baker Acquisitions, Inc.
• Jordon Baker Acquisitions, Inc.
• Carolyn Kelly Mueller, D.M.D.
• Laboratory Corporation of America Holdings
• Laura Kathryn Loudin
• Samantha S McIntosh, FNP
• MH Mission Hospital, LLLP
• Mission Hospitals Inc
• Mitchell County Department of Social Services

• General Practice Dentistry in Bakersville, NC
• Providers in Bakersville, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.