Active NPI
Corliss Jean Furbert, DDS, MPH,PA
- Pediatric Dentistry
- Raleigh, NC
National Provider Identifier
1811040371
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 06907
- Practice address
- 3901 Barrett Dr
Suite 103
Raleigh, NC 27609-6611 - Phone
- (919) 900-8235
- Fax
- (919) 900-8237
- NPI assigned
- Jan 19, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 06907 | NC | Primary |
Addresses
Primary practice location
3901 Barrett Dr
Suite 103
Raleigh, NC 27609-6611
Mailing address
12309 Staunton CT
Raleigh, NC 27613-6831
Phone (919) 676-4772
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 06907 | NC | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Corliss J Furbert, DDS,PA | Pediatric Dentistry | Current | Accepting new patients |
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.
-
- Pediatric Dentistry
- Knightdale, NC
- NPI 1710608781
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169164800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1273104000000",
"number": "1811040371",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12309 STAUNTON CT",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276136831",
"telephone_number": "919-676-4772"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3901 BARRETT DR",
"address_2": "SUITE 103",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276096611",
"telephone_number": "919-900-8235",
"fax_number": "919-900-8237"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FURBERT",
"first_name": "CORLISS",
"middle_name": "JEAN",
"name_prefix": "Dr.",
"credential": "DDS, MPH,PA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-19",
"last_updated": "2010-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "NC",
"license": "06907",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.