Dustin Christopher Jacobs, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN013782 Issued in GA

Practice address

1930 Buford Mill Dr
Buford, GA 30519-8602

Phone

(770) 882-2539

NPI assigned

Jul 16, 2008

Sex

Male

Sole proprietor

No

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

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Choice One Dental Care

  • General Practice Dentistry
  • Buford, GA
  • NPI 1114086477
  NPD

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

{
    "created_epoch": "1216166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407369600000",
    "number": "1023272358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 BUFORD MILL DR",
            "city": "BUFORD",
            "state": "GA",
            "postal_code": "305198602",
            "telephone_number": "770-882-2539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 BUFORD MILL DR",
            "city": "BUFORD",
            "state": "GA",
            "postal_code": "305198602",
            "telephone_number": "770-882-2539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "DUSTIN",
        "middle_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-16",
        "last_updated": "2014-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN013782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Surrea Oglesby Ivy
• Heather Jackson, OTR/L
• Jubrenza Renae Jackson, APC
• Monique Lasean Jackson, MA
• Sophia Evette Jackson, NP
• James E Carter, IV, DMD, PC
• Raquel Renee James, LMSW
• Min Ji Elizabeth Jang, OD
• Glory Jason, RN,N.P
• Jong In Jeoung, DMD

• General Practice Dentistry in Buford, GA
• Providers in Buford, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.