Provider Demographics
NPI:1972481083
Name:K. JASINSKI, D.M.D., P.C.
Entity type:Organization
Organization Name:K. JASINSKI, D.M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:CEMYIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCDOUGAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-764-8609
Mailing Address - Street 1:2432 JEFFRESS RD
Mailing Address - Street 2:
Mailing Address - City:MILLS RIVER
Mailing Address - State:NC
Mailing Address - Zip Code:28759-3865
Mailing Address - Country:US
Mailing Address - Phone:828-671-4150
Mailing Address - Fax:
Practice Address - Street 1:2432 JEFFRESS RD
Practice Address - Street 2:
Practice Address - City:MILLS RIVER
Practice Address - State:NC
Practice Address - Zip Code:28759-3865
Practice Address - Country:US
Practice Address - Phone:828-671-4150
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:K. JASINSKI, D.M.D., P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-08-26
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty