Jacob Brotzman DMD PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

JACOB BROTZMAN DMD PLLC

Doing business as

Restoration Dental

Practice address

4721 Country Club Rd
Winston Salem, NC 27104-3521

Phone

(919) 961-8552

NPI assigned

Nov 29, 2023

Organization subpart

No

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

Authorized official

Name

Jacob Brotzman, DMDNPI 1942882519

Title

General Dentist

Phone

(919) 961-8552

Specialties & licenses 1

Addresses

Other names 1

• Restoration Dental Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jacob Brotzman, DMD

  • General Practice Dentistry
  • Winston Salem, NC
  • NPI 1942882519
  NPD Authorized official

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

{
    "created_epoch": "1701216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701216000000",
    "number": "1699541813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 E DEVONSHIRE ST",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271273033",
            "telephone_number": "919-961-8552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4721 COUNTRY CLUB RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271043521",
            "telephone_number": "919-961-8552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACOB BROTZMAN DMD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-29",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A",
        "authorized_official_last_name": "BROTZMAN",
        "authorized_official_first_name": "JACOB",
        "authorized_official_title_or_position": "GENERAL DENTIST",
        "authorized_official_telephone_number": "919-961-8552",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Restoration Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Teresa B. Jackson, RPH.
• Tommie S. Jackson
• Toni Beth Jackson, PA-C
• Travis Harold Jackson, MD
• Vivian Sapphira Jackson
• Jose Guadalupe Jacobo Pacheco
• Garcia Jacobs Harris
• Bradley Edgar Jacobs, MD
• Kimura Garcia Chermez'S Jacobs, PA-C
• Traci Jacobs, PHARM.D

• Dental Clinic/Center in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Dental Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2023; 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.