Jacob Keith Burch, DMD
Individual provider Active NPI General Practice Dentistry · Kinston, NC
NPI 1003548405 · NPPES record last updated Jun 26, 2022
Key facts
- NPI
- 1003548405
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 12843 (NC)
- Practice address
- 801 Plaza Blvd
Kinston, NC 28501-2143 - Phone
- (252) 371-0117
- NPI assigned
- Jun 26, 2022
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12843 | NC | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 12843 | NC | Yes |
Addresses
Primary practice location
801 Plaza Blvd
Kinston, NC 28501-2143
Mailing address
2004 Charity LN
Winterville, NC 28590-7972
Phone (252) 676-5500
Other providers in Kinston, NC
- Mackenzie Payne Brown
- William H Brown
- Marcia L. Brumbaugh
- Melinda Bryant
- Glenn E. Bunch Jr.
- James G Burke Jr.
- Barbara Grady Byrd
- Sarah Arnette Byrd
- Michael P Byrne
- Kathleen M Cameron
All providers in Kinston, NC · General Practice Dentistry in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 26, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.