DR. JACK DOUGLAS KING (NPI# 1811992332) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811992332 |
| Entity Type | Individual |
| Full Name | DR. JACK DOUGLAS KING |
| Credential | DDS |
| Practice Address |
1706 Davie Ave Ste B Statesville NC 28677-3589 |
| Mailing Address |
3215 Meadow Rue Ln Statesville NC 28625-4562 |
| Practice Telephone | 7048731968 |
| Practice Fax Number | 7048725841 |
| Mailing Telephone | 7048721702 |
| Enumeration Date | 2005-06-21 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
5157 | NC | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649811902 | Jack King | Speech-Language Pathologist | 2501 Rice Lake Rd, Duluth, MN 55811-4819 | 2019-10-07 |
| 1477916450 | Jack D King IIi | Technician, Other | 440 N Main St, Imlay City, MI 48444-1151 | 2016-03-29 |
| 1164563706 | Jack Donald King Jr. | Family Medicine | 1826 Ailor Ave, Knoxville, TN 37921-5802 | 2007-02-08 |
| 1922050780 | Jack Dennis King | Pediatrics | 3094 W Market St, Suite 103, Fairlawn, OH 44333-3626 | 2006-05-17 |
| Street Address |
1706 DAVIE AVE STE B |
| City | STATESVILLE |
| State | NC |
| Zip Code | 28677-3589 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 1407129877 | Jack D. King, Dds, Pa | Clinic/Center | 1706 Davie Ave, Suite B, Statesville, NC 28677-3589 | 2012-02-16 |
| 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 | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023643582 | Youngchi Chang Dds Pllc | Dentist | 964 Glenway Ave Ste A, Statesville, NC 28625 | 2020-03-05 |
| 1538799200 | Nicole-marie Blischak | Dentist | 964 Glenway Dr, Ste A, Statesville, NC 28625 | 2020-01-22 |
| 1689924367 | Timothy Crouch | Dentist | 511 Brookdale Dr, Statesville, NC 28677-4107 | 2012-09-11 |
| 1609007475 | Amanda Brown Kotis | Dentist | 1207 Davie Ave, Statesville, NC 28677-3511 | 2009-07-28 |
| 1538330295 | John P Mcginty Dds | Dentist | 120 S Tradd Street, Statesville, NC 28677-5863 | 2008-03-20 |
| 1124216817 | Dan E Carroll | Dentist | 1712 Davie Ave, Statesville, NC 28677-3522 | 2007-10-09 |
| 1932397924 | Shawn Nicholas Wolff | Dentist | 1424a Fern Creek Dr, Statesville, NC 28625-9376 | 2007-10-04 |
| 1477767655 | Thomas Allison Morris | Dentist | 2515 W Front St, Statesville, NC 28677-2999 | 2007-05-09 |
| 1437374964 | Thomas Raymond O'leary | Dentist | 701 Hartness Rd, Statesville, NC 28677-3424 | 2007-04-17 |
| 1538384888 | James E. Hunter Jr. | Dentist | 734 Bryant St, Statesville, NC 28677-4143 | 2007-04-13 |
| Find all providers in STATESVILLE | ||||
| City | STATESVILLE |
| Zip Code | 28677 |
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| 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.