# JYOTIMALLIKA, D.M.D., P.L.L.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376429043
- **Authorized official:** ASHISH SINGH (MANAGER)
- **Authorized official phone:** (252) 767-9619

## Contact information

- **Practice address:** 568 RUIN CREEK RD STE 127, HENDERSON, NC 27536-2881
- **Practice address phone:** (252) 430-7110
- **Mailing address:** 568 RUIN CREEK RD STE 127, HENDERSON, NC 27536-2881

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 08/15/2025
- **Last updated:** 08/24/2025