Active NPI
Jacob S Dunn, D.M.D., M.S.
- Oral and Maxillofacial Radiology Dentistry
- Draper, UT
National Provider Identifier
1063781425
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral and Maxillofacial Radiology Dentistry
- License
- 7827882-9922
- Practice address
- 12180 S 300 E Unit 656
Draper, UT 84020-2629 - Phone
- (702) 483-8664
- NPI assigned
- Dec 14, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral and Maxillofacial Radiology Dentistry | 1223X0008X | 59617 | CA | |
| Oral and Maxillofacial Radiology Dentistry | 1223X0008X | 7827882-9922 | UT | Primary |
Addresses
Primary practice location
12180 S 300 E Unit 656
Draper, UT 84020-2629
Mailing address
12180 S 300 E Unit 656
Draper, UT 84020-2629
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7827882-9922 | UT | MD | Oral and Maxillofacial Radiology Dentist |
| 59617 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1323820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1512345600000",
"number": "1063781425",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12180 S 300 E UNIT 656",
"city": "DRAPER",
"state": "UT",
"postal_code": "840202629"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12180 S 300 E UNIT 656",
"city": "DRAPER",
"state": "UT",
"postal_code": "840202629",
"telephone_number": "702-483-8664"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUNN",
"first_name": "JACOB",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "D.M.D., M.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-12-14",
"last_updated": "2017-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0008X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Radiology",
"state": "CA",
"license": "59617",
"primary": false
},
{
"code": "1223X0008X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Radiology",
"state": "UT",
"license": "7827882-9922",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Draper, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.