Active NPI
Jessie Mondestin, DMD
- Dentist
- Winston Salem, NC
National Provider Identifier
1881866192
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 7942
- Practice address
- 3320 Silas Creek Pkwy
Suite 576
Winston Salem, NC 27103-3031 - Phone
- (336) 768-8228
- NPI assigned
- Mar 26, 2008
- Last updated
- Mar 26, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 7942 | NC | Primary |
Addresses
Primary practice location
3320 Silas Creek Pkwy
Suite 576
Winston Salem, NC 27103-3031
Mailing address
3320 Silas Creek Pkwy
Suite 576
Winston Salem, NC 27103-3031
Phone (336) 768-8228
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7942 | NC | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1206489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1206489600000",
"number": "1881866192",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3320 SILAS CREEK PKWY",
"address_2": "SUITE 576",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271033031",
"telephone_number": "336-768-8228"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3320 SILAS CREEK PKWY",
"address_2": "SUITE 576",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271033031",
"telephone_number": "336-768-8228"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MONDESTIN",
"first_name": "JESSIE",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-03-26",
"last_updated": "2008-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NC",
"license": "7942",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winston Salem, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.