Individual provider Active NPI

Solomon Jacobs, D.M.D.

  • Dentist
  • Atlanta, GA
National Provider Identifier
1083062228
Registry record updated Mar 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN015307 Issued in GA
Practice address
5600 Roswell Rd Ste K120
Atlanta, GA 30342-1262
Phone
(404) 809-3400
NPI assigned
May 27, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN015307 GA Primary

Addresses

Primary practice location

5600 Roswell Rd Ste K120
Atlanta, GA 30342-1262

Mailing address

5600 Roswell Rd Ste K120
Atlanta, GA 30342-1262

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
DN015307GAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Dentistry of Sandy Springs LLC CurrentSince Mar 20, 2022 Accepting new patients
Covington Dental Care Past Accepting new patients
Covington Dental Care Past Accepting new patients

Locations

5600 Roswell Rd
Ste K120
Sandy Springs, GA 30342
Phone (404) 809-3400

Organizations & group practices 3

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": "1464307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647475200000",
    "number": "1083062228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5600 ROSWELL RD STE K120",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5600 ROSWELL RD STE K120",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421262",
            "telephone_number": "404-809-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "SOLOMON",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-27",
        "last_updated": "2022-03-17",
        "certification_date": "2022-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN015307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2022; 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.