Organization Active NPI

Jacob Dent DDS Elmwood Modern Dentistry a Professional Corporation

  • General Practice Dentistry
  • Harahan, LA
National Provider Identifier
1003709676
Registry record updated Jun 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
JACOB DENT DDS ELMWOOD MODERN DENTISTRY A PROFESSIONAL CORPORATION
Practice address
1208 S Clearview Pkwy Ste C
Harahan, LA 70123-2557
Phone
(504) 224-9093
NPI assigned
Jun 2, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jacob Dent
Title
Owner
Phone
(714) 845-8500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

1208 S Clearview Pkwy Ste C
Harahan, LA 70123-2557

Mailing address

PO Box 660041
Dallas, TX 75266-0041

National Provider Directory

National Provider Directory

Locations

1208 S Clearview Pkwy
Ste C
Harahan, LA 70123
Phone (504) 224-9093

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1748822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748822400000",
    "number": "1003709676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 660041",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752660041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1208 S CLEARVIEW PKWY STE C",
            "city": "HARAHAN",
            "state": "LA",
            "postal_code": "701232557",
            "telephone_number": "504-224-9093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACOB DENT DDS ELMWOOD MODERN DENTISTRY A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-02",
        "last_updated": "2025-06-02",
        "certification_date": "2025-06-02",
        "status": "A",
        "authorized_official_last_name": "DENT",
        "authorized_official_first_name": "JACOB",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "714-845-8500"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harahan, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.