Provider Demographics
NPI:1477137974
Name:JENKINS, ADAM CHRISTOPHER (DMD)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:CHRISTOPHER
Last Name:JENKINS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4650 ATRIUM CT
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28405-0201
Mailing Address - Country:US
Mailing Address - Phone:803-920-5057
Mailing Address - Fax:
Practice Address - Street 1:7028 WRIGHTSVILLE AVE
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-3655
Practice Address - Country:US
Practice Address - Phone:910-256-8486
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-11
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC9239122300000X, 1223P0300X
NC121981223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodontics
No122300000XDental ProvidersDentistGroup - Single Specialty