JACK D. KING, DDS, PA (NPI# 1407129877) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407129877 |
| Entity Type | Organization |
| Organization Name | JACK D. KING, DDS, PA |
| Practice Address |
1706 Davie Ave Suite B Statesville NC 28677-3589 |
| Practice Telephone | 7048731968 |
| Practice Fax Number | 7048725841 |
| Mailing Telephone | 7048731968 |
| Mailing Fax Number | 7048725841 |
| Enumeration Date | 2012-02-16 |
| Last Update Date | 2012-02-16 |
| Authorized Official Name | DR. JACK DOUGLAS KING (PRESIDENT) |
| Authorized Official Telephone | 7048731968 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
5157 | NC | Ambulatory Health Care Facilities |
| Street Address |
1706 DAVIE AVE SUITE B |
| City | STATESVILLE |
| State | NC |
| Zip Code | 28677-3589 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811992332 | Jack Douglas King | Dentist | 1706 Davie Ave, Ste B, Statesville, NC 28677-3589 | 2005-06-21 |
| 1568836930 | Dr Allen J Romeo & Associates Pllc | Psychologist | 1706 Davie Ave, Statesville, NC 28677-3589 | 2015-11-21 |
| 1386021020 | Robert L Schmidt Dmd Pllc | Clinic/Center | 1706 Davie Ave, Suite B, Statesville, NC 28677-3589 | 2015-05-01 |
| 1104178169 | Robert Logan Schmidt | Dentist | 1706 Davie Ave, Suite B, Statesville, NC 28677-3589 | 2012-10-15 |
| 1700098365 | Rebecca White Romeo | Counselor | 1706 Davie Ave, Statesville, NC 28677-3589 | 2007-05-04 |
| 1659408557 | Allen Joseph Romeo | Psychologist | 1706 Davie Ave, Statesville, NC 28677-3589 | 2007-02-27 |
| 1245347335 | Elaine Sharon Crummett | Counselor | 1706 Davie Ave, Suite D, Statesville, NC 28677-3589 | 2006-08-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306472311 | Crystal Medley Hopkins | Nurse Practitioner | 105 Summer Breeze Court, Statesville, NC 28677 | 2020-03-21 |
| 1922634484 | Tracey Holton | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | Easterseals Ucp, 913 Carolina Ave N, Statesville, NC 28677 | 2020-03-17 |
| 1962069286 | Leap Child & Family Services LLC | Developmental Therapist | 119 North Tradd Street, Statesville, NC 28677 | 2019-05-22 |
| 1831604891 | Ingles Markets Inc | Pharmacy | 722 Sullivan Rd, Statesville, NC 28677 | 2017-12-12 |
| 1235663162 | Sandra Lorraine Scalese | Physical Therapy Assistant | 520 Valley Street, Brian Center Health and Rehabilitation, Statesville, NC 28677 | 2017-04-18 |
| 1437698891 | Sherry Blevins Hager | Pharmacist | 722 Sullivan Road, Statesville, NC 28677 | 2017-02-17 |
| 1063828507 | Susan Marie S Sheffield | Dentist | 518 Brookdale Drive, Statesville, NC 28677 | 2014-07-04 |
| 1659782449 | Easter Seals Ucp | Community/Behavioral Health | 913 Carolina Ave, Statesville, NC 28677 | 2014-05-14 |
| 1306268016 | Randall Scott Perry | Dentist | 1132 Davie Avenue, Statesville, NC 28677 | 2014-01-15 |
| 1215215876 | Silhouette Enterprises | Prosthetic/Orthotic Supplier | 909 Carolina Ave, Statesville, NC 28677 | 2011-08-01 |
| Find all providers in zip 28677 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093790859 | County of Iredell | Clinic/Center | 318 Turnersburg Hwy, Statesville, NC 28625-2798 | 2005-12-14 |
| 1386021020 | Robert L Schmidt Dmd Pllc | Clinic/Center | 1706 Davie Ave, Suite B, Statesville, NC 28677-3589 | 2015-05-01 |
| 1386067908 | County of Iredell | Clinic/Center | 318 Turnersburg Hwy, Statesville, NC 28625-2798 | 2014-02-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679170419 | Jones Kofford & Smith Dds Iv Pllc | Clinic/Center | 2420 Penny Rd, High Point, NC 27265-8120 | 2020-10-05 |
| 1871109041 | Steven D Robertson Dmd, Pa | Clinic/Center | 1613 Montford Dr Ste A, Charlotte, NC 28209-3793 | 2020-09-22 |
| 1477168532 | Caitlin Singleton Dds Pllc | Clinic/Center | 804 Desert Harbor Pl, Cary, NC 27519-9632 | 2020-09-14 |
| 1285243808 | Maja V Martin Dds Pa II | Clinic/Center | 4203 Corners Pkwy, Ste 100, Raleigh, NC 27617 | 2020-07-29 |
| 1265050504 | Hammock, Dmd & Lotakis, Dds X, Pllc | Clinic/Center | 9201 S Tryon St Ste A, Charlotte, NC 28273-4239 | 2020-07-13 |
| 1811514185 | Craig M. Mize Dds, Pa | Clinic/Center | 8300 Falls of Neuse Rd Ste 114, Raleigh, NC 27615-3450 | 2020-07-02 |
| 1730706110 | Maja V Martin, Dds, Pa1 | Clinic/Center | 7371 Six Forks Road, Raleigh, NC 27615 | 2020-07-01 |
| 1194349407 | Michelakis and Associates Pa | Clinic/Center | 1132 New Pointe Blvd Ste 4, Leland, NC 28451-4257 | 2020-06-02 |
| 1427677624 | New Hope Clinic, Inc. | Clinic/Center | 201 W Boiling Spring Rd, Southport, NC 28461-9730 | 2020-04-09 |
| 1699301440 | Tran and Javed Dds Pa | Clinic/Center | 6604 E Marshville Blvd Ste 1, Marshville, NC 28103-1198 | 2020-03-12 |
| Find all providers with the same taxonomy | ||||
| City | STATESVILLE |
| Zip Code | 28677 |
Please comment or provide details below to improve the information on JACK D. KING, DDS, PA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.