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JACOB BROTZMAN DMD PLLC
NPI 1699541813
Clinic/Center - Dental in Winston Salem, NC

Active since November 29, 2023
4721 COUNTRY CLUB RD, WINSTON SALEM, NC 27104(919) 961-8552 Get Directions Write a Review

NPPES record last updated: November 29, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Table of Contents

  1. NPI Profile Information
  2. Primary Taxonomy
  3. Authorized Official
  4. Frequently Asked Questions
  • Organization
  • Clinic/Center
  • Dental

About JACOB BROTZMAN DMD PLLC

This page provides the complete NPI Profile along with additional information for Jacob Brotzman Dmd Pllc, a provider established in Winston Salem, North Carolina operating as a Clinic/center, focusing in dental . The healthcare provider is registered in the NPI registry with number 1699541813 assigned on November 2023. The practitioner's primary taxonomy code is 261QD0000X. The provider is registered as an organization and their NPI record was last updated 3 years ago. The authorized official of this NPI record is Jacob Brotzman Dmd (General Dentist)

NPI
1699541813 Verify this NPI
Provider Name
JACOB BROTZMAN DMD PLLC
Entity Type
Organization
Location Address
4721 COUNTRY CLUB RD WINSTON SALEM, NC 27104
Location Phone
(919) 961-8552
Mailing Address
14 E DEVONSHIRE ST WINSTON SALEM, NC 27127
Mailing Phone
(919) 961-8552
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
11-29-2023
Last Update Date
11-29-2023
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Dental

Taxonomy Code
261QD0000X
Type
Ambulatory Health Care Facilities

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

JACOB BROTZMAN DMD

Authorized Official Title
GENERAL DENTIST
Authorized Official Phone
(919) 961-8552

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Frequently Asked Questions

What is JACOB BROTZMAN DMD PLLC's NPI number?

The NPI number assigned to this healthcare provider is 1699541813, enumerated as an "organization" on November 29, 2023.

Where is the provider located?

The provider is located at 4721 COUNTRY CLUB RD WINSTON SALEM, NC 27104 and the phone number is (919) 961-8552.

What is the provider's specialty?

Clinic/Center with taxonomy code 261QD0000X and a focus in Dental.