Jacob Brotzman, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12284 Issued in NC

Practice address

140 Lockland Ave
Winston Salem, NC 27103-2709

Phone

(336) 722-7534

NPI assigned

Apr 23, 2021

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

State licenses

Practice roles

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

• Jacob Brotzman DMD PLLC

  dba Restoration Dental

  • Dental Clinic/Center
  • Winston Salem, NC
  • NPI 1699541813
  NPD Authorized official
• Charlotte Broughton, DDS

  • Dentist
  • Winston Salem, NC
  • NPI 1003089111
  NPD (past)
• Steve Felts, DDS

  • Dentist
  • Winston Salem, NC
  • NPI 1760655872
  NPD (past)

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

{
    "created_epoch": "1619136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624406400000",
    "number": "1942882519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 TREYBROOKE CIR APT 31",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278347893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 LOCKLAND AVE",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271032709",
            "telephone_number": "336-722-7534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROTZMAN",
        "first_name": "JACOB",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-23",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "12284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shelby Brookshire, PHARMD
• Brookview Womens Center PLLC
• William Carroll Broome, D.M.D.
• Justin Kenneth Brooten, MD
• Tamara Kathleen Brothers, CNM
• Charlotte W Broughton, DDS
• Danielle Briana Brower, CRNA
• A'Niyah N Brown, MA, CFY-SLP
• Alessandra Hardigan Brown, FNP
• Alicia Brown, LCMHCA, LCAS

• General Practice Dentistry in Winston Salem, NC
• Providers in Winston Salem, 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 Jun 23, 2021; 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.