Jacksyn Clanton, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

13495 Issued in NC

Practice address

545 US 70 Hwy E
Garner, NC 27529-4046

Phone

(919) 809-5012

NPI assigned

Apr 13, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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

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.

• K. Jasinski, D.M.D., P.C.

  dba Fuquay Family Dentistry

  • General Practice Dentistry
  • Fuquay Varina, NC
  • NPI 1154966216
  NPD (past)

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

{
    "created_epoch": "1649808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718150400000",
    "number": "1902548506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "545 US 70 HWY E",
            "city": "GARNER",
            "state": "NC",
            "postal_code": "275294046",
            "telephone_number": "919-809-5012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 US 70 HWY E",
            "city": "GARNER",
            "state": "NC",
            "postal_code": "275294046",
            "telephone_number": "919-809-5012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLANTON",
        "first_name": "JACKSYN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-13",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "13495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anthony P Christy, CRT, RCP
• Nicole Lynne Cicchini, LCASA
• Anna Jeanne Ciccolini, PA-C
• Emily Cintron
• Karly Cirillo
• Clarity Clinical Counseling
• Crystal Marie Clark, PA-C
• Lauren Rose Clark
• Samaria Ny'Shai Clark
• Sharodera Clark

• Dentist in Garner, NC
• Providers in Garner, NC by specialty
• Dentist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2024; 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.