Brian James Jacobsen, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

DE60128176 Issued in WA

Practice address

103 1St Ave SW
Ephrata, WA 98823-2197

Phone

(509) 754-3262

NPI assigned

Nov 18, 2008

Last updated

Feb 4, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Brian J Jacobsen DMD PC

  dba Jacobsen Dental

  • Dentist
  • Ephrata, WA
  • NPI 1942758180
  NPD Authorized official

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

{
    "created_epoch": "1226966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454544000000",
    "number": "1013162098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 1ST AVE SW",
            "city": "EPHRATA",
            "state": "WA",
            "postal_code": "988231842",
            "telephone_number": "509-754-3262",
            "fax_number": "509-754-4975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 1ST AVE SW",
            "city": "EPHRATA",
            "state": "WA",
            "postal_code": "988232197",
            "telephone_number": "509-754-3262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSEN",
        "first_name": "BRIAN",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-11-18",
        "last_updated": "2016-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60128176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Hesse, O.D.
• Christy Hill, L.M.P.
• Kathleen Holloway, PA-C
• Kayla Rae Huber
• Yoon Jea Im
• Poonam Kalsi
• Eve Keen, LMP
• Rebecca Marie Long, MSN RN CWCN
• Evelin Lopez-Sanchez
• Ann E Mackenzie, L.M.P.

• Dentist in Ephrata, WA
• Providers in Ephrata, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2016; 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.