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Active NPI 1063441616 Individual Practitioner Male Practitioner

Kerry P Cogburn , DDSPA

Dentist - General Practice • Clyde, NC

Professional Overview & Biography Verified Profile Summary

Kerry Cogburn, DDSPA is a registered healthcare professional specializing in Dentist - General Practice in Clyde, NC. Practice services are available at 418 JONES COVE RD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

418 Jones Cove Rd

Clyde, NC 287219458

Telephone 8286279285
Fax 8286279287
Associated Practice Facility / Clinic
🏢 Kerry P. Cogburn, Dds, Pa Facility NPI 1952574261

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Clyde, NC

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 11.6 Yrs
Regional Practice Density
6 Specialists

Practicing in Clyde, NC (4047 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License NC 3906

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
8991701 (NC)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 08, 2007

Registered at 418 JONES COVE RD, CLYDE, NC 287219458 (Tel: 8286279285)

📍
Updated Business Mailing Address July 08, 2007

Registered at 272 STONEY BROOK DR, CLYDE, NC 287218537 (Tel: 8286276412)

👤
Provider Name / Credentials Updated July 08, 2007

Recorded as KERRY COGBURN, D.D.S. P.A.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist (License #3906 in NC)

🟢
Initial NPI Registration & Enumeration July 03, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1063441616
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 03, 2006
Last Update: July 08, 2007
Sole Proprietor: Yes

Mailing Address

272 Stoney Brook Dr

Clyde, NC 287218537

Phone: 8286276412

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.