Jacob Clifford Abbott, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

32091 Issued in TX

Practice address

8461 Boat Club Rd
Fort Worth, TX 76179

Phone

(817) 236-8771

NPI assigned

Sep 1, 2016

Last updated

Sep 1, 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

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

{
    "created_epoch": "1472688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472688000000",
    "number": "1134675770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8461 BOAT CLUB RD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76179",
            "telephone_number": "817-236-8771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8461 BOAT CLUB RD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76179",
            "telephone_number": "817-236-8771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABBOTT",
        "first_name": "JACOB",
        "middle_name": "CLIFFORD",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-09-01",
        "last_updated": "2016-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "32091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ibraheem Abbas, MD
• Abberrymangroup LLC
• Sheri Elaine Abbey, LCSW
• Vanessa Abbood, MS, RD, LD
• Abbott Clinic, PA
• Kendall Abbott, LMSW
• Abc 123 Dental Centers Professional (ABC 123 Dental and Orthodontics)
• Abc123 Dental in Haltom PLLC (ABC123 Dental)
• Nancy Abdelmeseh
• Abeer Marwan Abdelrahim, MD, MPH

• General Practice Dentistry in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 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.