NPIMap

Organization Active NPI

K. Jasinski, D.M.D., P.C.

Doing business as Owen Drive Family Dental

  • General Practice Dentistry
  • Fayetteville, NC
National Provider Identifier
1871234633
Registry record updated Oct 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
K. JASINSKI, D.M.D., P.C.
Doing business as
Owen Drive Family Dental
Practice address
203 Owen Dr
Fayetteville, NC 28304-3409
Phone
(910) 484-1771
NPI assigned
Apr 5, 2022
Last updated
Oct 4, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
K. JASINSKI, D.M.D., P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 4, 2024

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

Authorized official

Name
Hillary Thull
Title
Credentialing Coordinator
Phone
(217) 540-8946

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

203 Owen Dr
Fayetteville, NC 28304-3409

Mailing address

203 Owen Dr
Fayetteville, NC 28304-3409

Other names 1

  • Owen Drive Family Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
S Gibree DMD PC81 organizations share this tax ID, including this one
Part of
S Gibree DMD PC

Organizations with this tax ID in the same state 23

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 23

Locations

203 Owen Dr
Fayetteville, NC 28304
Phone (910) 484-1771

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1649116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728000000000",
    "number": "1871234633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 OWEN DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 OWEN DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043409",
            "telephone_number": "910-484-1771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "K. JASINSKI, D.M.D., P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "K. JASINSKI, D.M.D., P.C.",
        "enumeration_date": "2022-04-05",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A",
        "authorized_official_last_name": "THULL",
        "authorized_official_first_name": "HILLARY",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-8946"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Owen Drive Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Oct 4, 2024; 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.