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Jack Birch

NPI 1205682473ActiveIndividual· Dentist· Fort Campbell, KY

Dentist in Fort Campbell, Kentucky, licensed in WI, with an NPI issued in April 2024.

Overview

NPI1205682473
StatusActive
Entity typeIndividual
Sole proprietorNo
NPI issuedApr 27, 2024
Last updated in NPPESJul 30, 2025
Certified by providerJul 30, 2025

Specialties and licenses

TaxonomyCodeLicenseState
Dentist Primary122300000X6001525WI

About license numbers in NPPES

Exclusion screening

ListResultDetails
HHS-OIG LEIE · Oct 9, 2026No matchChecked by NPI and by name + state
North Carolina Medicaid · Nov 10, 2026No match—
New York OMIG · Nov 10, 2026No match—
Ohio Medicaid · Nov 10, 2026No match—
Pennsylvania Medicheck · Nov 10, 2026No match—
Washington HCA · Nov 10, 2026No match—

Official OIG search · How matching works ·Bulk check a roster

Medicare

Enrollment (PECOS)Not in the public enrollment file of Oct 1, 2026

Medicare sources and data years

Industry payments (Open Payments)

None reported for 2025 or 2024.

Receiving payments does not imply wrongdoing. What Open Payments covers ·original records

Other Dentist providers in Fort Campbell

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