NPIMap

Organization Active NPI

Jacobson Dental Corp

Doing business as Children's Choice Dental Care

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Modesto, CA
National Provider Identifier
1134737315
Registry record updated Mar 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
JACOBSON DENTAL CORP
Doing business as
Children's Choice Dental Care
Practice address
2057 Tully Road
Suite a
Modesto, CA 95350
Phone
(209) 353-3300
Fax
(844) 534-8464
NPI assigned
Jul 14, 2020
Last updated
Mar 6, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2024

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

Authorized official

Name
Dr. Jeffrey Jacobson, DMD
Title
Owner
Phone
(916) 877-7450

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X NU Primary

Addresses

Primary practice location

2057 Tully Road
Suite a
Modesto, CA 95350

Mailing address

3655 Torrance Blvd Ste 425
Torrance, CA 90503-4844
Phone (916) 877-7450

Other names 2

  • Children's Choice Dental Care Doing business as
  • Jacobson Dental Corp Other name

National Provider Directory

National Provider Directory
Tax ID family
Dr Jeffrey a Saladin Dental Corporation30 organizations share this tax ID, including this one

Other organizations with this tax ID 29

Organizations that report the same tax identification number in the National Provider Directory.

View all 29

Locations

2057 Tully Rd
Ste A
Modesto, CA 95350
Phone (209) 353-3300

NPI Registry JSON

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

{
    "created_epoch": "1594684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709683200000",
    "number": "1134737315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3655 TORRANCE BLVD STE 425",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905034844",
            "telephone_number": "916-877-7450",
            "fax_number": "844-534-8464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2057 TULLY ROAD",
            "address_2": "SUITE A",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "95350",
            "telephone_number": "209-353-3300",
            "fax_number": "844-534-8464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACOBSON DENTAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-14",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A",
        "authorized_official_last_name": "JACOBSON",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "916-877-7450",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Children's Choice Dental Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Children's Choice Dental Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Jacobson Dental Corp",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Modesto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2024; 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.