Jonathan Breazeale, DMD

Individual provider Active NPI General Practice Dentistry · Liberty, NC

NPI 1649015751 · NPPES record last updated Jul 15, 2026

Key facts

NPI
1649015751
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
14823 (NC)
Practice address
524 N Greensboro St
Liberty, NC 27298-2601
Phone
(336) 622-2951
NPI assigned
Jun 28, 2024
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Greg Moses DDS, PLLC Past
since Mar 7, 2021
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 14823 NC Yes

Addresses

Primary practice location

524 N Greensboro St
Liberty, NC 27298-2601

Mailing address

524 N Greensboro St
Liberty, NC 27298-2601
Phone (336) 622-2951

Other providers in Liberty, NC

All providers in Liberty, NC · General Practice Dentistry in North Carolina

Sources for this page

Verify at the official NPI Registry.