Provider Demographics
NPI:1154913069
Name:JERNIGAN, SYLVIA PECYNA (DDS)
Entity type:Individual
Prefix:DR
First Name:SYLVIA
Middle Name:PECYNA
Last Name:JERNIGAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:78 NELSON ST
Mailing Address - Street 2:
Mailing Address - City:CLYDE
Mailing Address - State:NC
Mailing Address - Zip Code:28721-9661
Mailing Address - Country:US
Mailing Address - Phone:828-627-9282
Mailing Address - Fax:
Practice Address - Street 1:78 NELSON ST
Practice Address - Street 2:
Practice Address - City:CLYDE
Practice Address - State:NC
Practice Address - Zip Code:28721-9661
Practice Address - Country:US
Practice Address - Phone:828-627-9282
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-11
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NC12132122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program