Provider Demographics
NPI:1427931237
Name:FORTKORT, JOSEPH (DDS)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:
Last Name:FORTKORT
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 NOVUS LN APT 526
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-6028
Mailing Address - Country:US
Mailing Address - Phone:704-530-1586
Mailing Address - Fax:
Practice Address - Street 1:11312 US 15-1501 NORTH
Practice Address - Street 2:SUITE 107-139
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27517
Practice Address - Country:US
Practice Address - Phone:919-545-0985
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-29
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14366122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist