Individual provider Active NPI

Jacob Lim Scheel, DDS

  • Endodontics
  • Portland, OR
National Provider Identifier
1063180446
Registry record updated Sep 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
D12204 Issued in OR
Practice address
6400 SE Lake Rd Ste 140
Portland, OR 97222-2194
Phone
(503) 496-4766
NPI assigned
Sep 1, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 30.027455 OH
General Practice Dentistry 1223G0001X 37759 CA
Endodontics 1223E0200X D12204 OR Primary

Addresses

Primary practice location

6400 SE Lake Rd Ste 140
Portland, OR 97222-2194

Mailing address

6400 SE Lake Rd Ste 140
Portland, OR 97222-2194
Phone (503) 496-4766

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
30.027455OHMDEndodontist
D12204ORMDEndodontist
37759CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Terry L Isom DMD,PC CurrentSince Sep 28, 2025 Accepting new patients

Locations

6400 SE Lake Rd
Ste 140
Portland, OR 97222
Phone (503) 496-4766

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1630454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758758400000",
    "number": "1063180446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 SE LAKE RD STE 140",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972222194",
            "telephone_number": "503-496-4766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6400 SE LAKE RD STE 140",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972222194",
            "telephone_number": "503-496-4766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHEEL",
        "first_name": "JACOB",
        "middle_name": "LIM",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-01",
        "last_updated": "2025-09-25",
        "certification_date": "2025-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "OH",
            "license": "30.027455",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "37759",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "OR",
            "license": "D12204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 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.