DR. MICHAEL CLARK KINNEBREW (NPI# 1346238862) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346238862 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL CLARK KINNEBREW |
| Credential | M.D., D.D.S. |
| Practice Address |
1122 Medical Center Dr Wilmington NC 28401-7305 |
| Practice Telephone | 9107622618 |
| Practice Fax Number | 9107635173 |
| Mailing Telephone | 9107622618 |
| Mailing Fax Number | 9107635173 |
| Enumeration Date | 2005-10-10 |
| Last Update Date | 2011-02-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0106X |
Dentist Specialization: Oral and Maxillofacial Pathology |
96000154 | NC | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | BLUE CROSS BLUE SHIELD | 49309 | 01 |
| NC | 8949309 | 05 | |
| UNITED CONCORDIA | 979443 | 01 | |
| NC | 8994921 | 05 | |
| NC | VOCATIONAL REHABILITATION | 10272203 | 01 |
| Street Address |
1122 MEDICAL CENTER DR |
| City | WILMINGTON |
| State | NC |
| Zip Code | 28401-7305 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568463131 | Jeffrey Scott Church | Surgery | 1122 Medical Center Dr, Wilmington, NC 28401-7305 | 2005-08-09 |
| 1245709021 | La Belle Vie Plastic Surgery PC | Plastic Surgery | 1122 Medical Center Dr, Wilmington, NC 28401-7305 | 2018-11-21 |
| 1750553517 | Ronald D. Gaitros, Dds, Ms, Pa | Dentist | 1122 Medical Center Dr, Wilmington, NC 28401-7305 | 2008-04-01 |
| 1558533315 | Michael C. Kinnebrew, Md, Dds, Pa | Dentist | 1122 Medical Center Dr, Wilmington, NC 28401-7305 | 2008-04-01 |
| 1811033137 | Carolinas Oral & Facial Surgery Center, Inc. | Dentist | 1122 Medical Center Dr, Wilmington, NC 28401-7305 | 2007-01-30 |
| 1942298443 | Ronald Dale Gaitros | Dentist | 1122 Medical Center Dr, Wilmington, NC 28401-7305 | 2005-10-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275002461 | Thrivetothrive, LLC | Physical Therapist | 1606 Physicians Drive, Inside Promina Health, Wilmington, NC 28401 | 2018-11-16 |
| 1841787454 | Kevin Christopher Panebianco | Family Medicine | 1911 S 17th St Ste 130a, Wilmington, NC 28401 | 2018-04-18 |
| 1518472588 | Michelle Bruin | Family Medicine | 415 S. 2nd Street, Wilmington, NC 28401 | 2017-12-12 |
| 1639617343 | Anna Farwell | Behavior Technician | 3904 Oleander Dr. Suite 102, Wilmington, NC 28401 | 2017-02-02 |
| 1588034144 | Dimitri Zivko Pitovski | Allergy & Immunology | 1099 Medical Center Dr Unit 100b, Wilmington, NC 28401 | 2015-09-25 |
| 1629457007 | Megan Havel | Counselor | 1512 E Lakeshore Drive, Wilmington, NC 28401 | 2015-05-19 |
| 1154709251 | Lance Hutchens | Dentist | 1611 Doctors Cir, Wilmington, NC 28401 | 2015-05-11 |
| 1609281161 | Diane Pittman Whitford | Counselor | 313 Walnut St., Wilmington, NC 28401 | 2014-06-24 |
| 1942550728 | Bryan Cole Chalk | Nurse Anesthetist, Certified Registered | 2131 S 17th Street, Wilmington, NC 28401 | 2012-09-19 |
| 1740566546 | Valerie Baars | Pharmacist | 2302 S 17th Street, Wilmington, NC 28401 | 2011-10-25 |
| Find all providers in zip 28401 | ||||
| Taxonomy Code | 1223P0106X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Pathology |
| The specialty of dentistry and discipline of pathology that deals with the nature, identification, and management of diseases affecting the oral and maxillofacial regions. It is a science that investigates the causes, processes, and effects of these diseases. The practice of oral and maxillofacial pathology includes research and diagnosis of diseases using clinical, radiographic, microscopic, biochemical, or other examinations. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063548626 | Robert N Arm | Dentist | 501 W 14th St Rm 2234, Dept of Oral Maxillofacial Surgery & Hospital Dentistry, Wilmington, DE 19801-1013 | 2007-02-26 |
| 1952385122 | Christiana Care Health Services, Inc | Dentist | 501 W. 14th Street, Wilmington Hospital, Wilmington, DE 19899 | 2005-12-01 |
| 1942298443 | Ronald Dale Gaitros | Dentist | 1122 Medical Center Dr, Wilmington, NC 28401-7305 | 2005-10-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366060386 | Makayla Brooke Gresham | Dentist | 120 Dental Circle, Chapel Hill, NC 27599 | 2020-07-07 |
| 1649761602 | Uday N Reebye, Md. Dmd, Pa | Dentist | 431 Keisler Dr Ste 101, Cary, NC 27518 | 2018-05-25 |
| 1457860272 | Hiromi Nakamura | Dentist | 5441g Koury Oral Health Science Bulding, Chapel Hill, NC 27599 | 2017-09-25 |
| 1669997144 | Wright and Associates Vii, Dds Pa | Dentist | 120 Ne Maynard Road Suite 100, Cary, NC 27513-8355 | 2017-08-07 |
| 1962819185 | Sasha Jane Betz | Dentist | 112 Solstice Cir, Cary, NC 27513-5209 | 2014-07-21 |
| 1891974937 | David Rittenhouse Kuhn Jr. | Dentist | 1902 N Sandhills Blvd Ste H, Aberdeen, NC 28315-2347 | 2007-10-25 |
| 1205930765 | Kenneth J. Benson, Dds | Dentist | 2081 Sheperds Vineyard Dr, Apex, NC 27502-6410 | 2006-09-12 |
| 1356364533 | James M Walter Jr. | Dentist | 3020 Maplewood Ave, Winston Salem, NC 27103-4012 | 2006-07-26 |
| 1316965411 | Alice Curran | Dentist | University of North Carolina School of Dentistry, Cb#7450, Chapel Hill, NC 27599-0001 | 2006-07-17 |
| 1114954211 | Valerie Ann Murrah | Dentist | Unc School of Dentistry, Cb# 7450, Chapel Hill, NC 27599-7450 | 2006-06-26 |
| Find all providers with the same taxonomy | ||||
| City | WILMINGTON |
| Zip Code | 28401 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.