Perry Stephen Justice Jr., D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6835 Issued in NC

Practice address

2117 Simonton Rd
Suite 403
Statesville, NC 28625-8403

Phone

(704) 873-8899

NPI assigned

Mar 6, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

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.

• Perry S Justice Jr DDS PA

  • General Practice Dentistry
  • Statesville, NC
  • NPI 1972882140
  NPD (past) Authorized official
• Londry & Modlin Xiv DDS PLLC

  • General Practice Dentistry
  • Statesville, NC
  • NPI 1851134829
  NPD (past)

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332806400000",
    "number": "1851421515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2575 MAHOGANY LN",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286029312",
            "telephone_number": "828-403-0089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2117 SIMONTON RD",
            "address_2": "SUITE 403",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286258403",
            "telephone_number": "704-873-8899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUSTICE",
        "first_name": "PERRY",
        "middle_name": "STEPHEN",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-06",
        "last_updated": "2012-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "6835",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "899015H",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tashe Alexandria Jones, LPN
• Joseph M. Perry, DDS, PA
• Raj Kumar Joshi, M.D.
• Journey Center
• Jillian T Joyner
• Cecilia Kaechele, NP
• Gail Patricia Kailbourne, MS CSP, LPC
• Kristen Sara Karanikas, OTR/L
• Neil M Kassman, M.D.
• Matthew S Katsamas

• General Practice Dentistry in Statesville, NC
• Providers in Statesville, 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 Mar 27, 2012; 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.