Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jack Birch

Individual provider Dentist · NPI 1205682473

Jack Birch is a Dentist in Fort Campbell, Kentucky. Licensed in Wisconsin. Registered with an NPI since 2024.

Licensed in
WI
In the registry since
2024

Practice location Address checks out

650 Joel Dr
Fort Campbell, KY 42223-5318
Phone: (270) 798-8400
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 6001525 (WI)

Record details

NPI number1205682473
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedApril 27, 2024
Last updated in NPPESJuly 30, 2025
Certification dateJuly 30, 2025
Mailing address1801 W Wisconsin Ave, Milwaukee, WI 53233-2186

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