Jeremy Dustin Brock, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12842 Issued in NC

Practice address

10868 US Highway 15 501 Ste 100
Southern Pines, NC 28387-5149

Phone

(910) 295-5980

NPI assigned

Mar 15, 2022

Last updated

Sep 8, 2026By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1647302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788825600000",
    "number": "1386392629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10868 US 15 501 HWY STE 100",
            "city": "SOUTHERN PINES",
            "state": "NC",
            "postal_code": "283875149",
            "telephone_number": "910-295-5980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10868 US HIGHWAY 15 501 STE 100",
            "city": "SOUTHERN PINES",
            "state": "NC",
            "postal_code": "283875149",
            "telephone_number": "910-295-5980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCK",
        "first_name": "JEREMY",
        "middle_name": "DUSTIN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-15",
        "last_updated": "2026-09-08",
        "certification_date": "2026-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "12842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Brion Montalvo
• Natalie Britland
• Nina Diane Britt, COTA
• Sondra Britt, PTA
• Madison Broadwell, PMHNP
• Melissa Kaitlin Bronson, LCMHC ASSOCIATE
• Debbie Kathleen Brown, LMFT
• Lamesha Brown
• Taylor Brozovic
• Barry K Buchele, MD

• General Practice Dentistry in Southern Pines, NC
• Providers in Southern Pines, 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 Sep 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.