Healthcare Provider Details

I. General information

NPI: 1821799248
Provider Name (Legal Business Name): FAITH MUMBUA JOSEPH WITT DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: FAITH MUMBUA JOSEPH DDS

II. Dates (important events)

Enumeration Date: 03/13/2023
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 REGIONAL CIR STE A
PINEHURST NC
28374-9845
US

IV. Provider business mailing address

3 REGIONAL CIR STE A
PINEHURST NC
28374-9845
US

V. Phone/Fax

Practice location:
  • Phone: 910-215-2583
  • Fax:
Mailing address:
  • Phone: 910-215-2583
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number13343
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: