NPIMap

Organization Active NPI

Charles L Brandenburg III DDS

  • Dentist
  • Jamestown, NC
National Provider Identifier
1972787083
Registry record updated Dec 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6010 Issued in NC
Legal business name
CHARLES L BRANDENBURG III DDS
Practice address
5011D Mackay Rd
Jamestown, NC 27282
Phone
(336) 852-8383
Fax
(336) 856-1318
NPI assigned
Dec 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2007

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

Authorized official

Name
Charles L Brandenburg III, DDSNPI 1962686071
Title
Dentist
Phone
(336) 852-8383

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 6010 NC Primary

Addresses

Primary practice location

5011D Mackay Rd
Jamestown, NC 27282

Mailing address

5011D Mackay Rd
Jamestown, NC 27282
Phone (336) 852-8383

National Provider Directory

National Provider Directory

Locations

5011 Mackay Rd
Ste D
Jamestown, NC 27282
Phone (336) 852-8383

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1198627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198627200000",
    "number": "1972787083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5011D MACKAY RD",
            "city": "JAMESTOWN",
            "state": "NC",
            "postal_code": "27282",
            "telephone_number": "336-852-8383",
            "fax_number": "336-856-1318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5011D MACKAY RD",
            "city": "JAMESTOWN",
            "state": "NC",
            "postal_code": "27282",
            "telephone_number": "336-852-8383",
            "fax_number": "336-856-1318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES L BRANDENBURG III DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-26",
        "last_updated": "2007-12-26",
        "status": "A",
        "authorized_official_last_name": "BRANDENBURG",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "336-852-8383",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NC",
            "license": "6010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamestown, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2007; 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.