Chad Jerome Kimbrough, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9593 Issued in NC

Practice address

992 Gateway Commons Cir
Wake Forest, NC 27587-6594

Phone

(984) 302-7665

Fax

(843) 228-5196

NPI assigned

Nov 28, 2005

Last updated

Mar 21, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Interoperability endpoints

• Direct secure messaging: chad.kimbroughdds.p1@direct.personfamily.nextgenshare.com

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1133136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742515200000",
    "number": "1154304889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6216A",
            "address_2": "NAVAL HOSPITAL BEAUFORT, ATTN: PROF AFFAIRS COORDINATOR",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299026148",
            "telephone_number": "843-228-5577",
            "fax_number": "843-228-5196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "992 GATEWAY COMMONS CIR",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275876594",
            "telephone_number": "984-302-7665",
            "fax_number": "843-228-5196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMBROUGH",
        "first_name": "CHAD",
        "middle_name": "JEROME",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-28",
        "last_updated": "2025-03-21",
        "certification_date": "2025-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "9593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Wake Forest, NC
• Providers in Wake Forest, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.