Charles B Jakobsen

Primary specialty

DentistTaxonomy code 122300000X

License

6266 Issued in AZ

Legal business name

CHARLES B JAKOBSEN

Practice address

7617 S Central Ave
Phoenix, AZ 85042-6513

Phone

(602) 268-7076

NPI assigned

Nov 20, 2014

Organization subpart

No

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

Authorized official

Name

Mrs. Ginny L Wood

Title

Office Manager

Phone

(602) 268-7076

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Albright Dental Care Doing business as

Locations

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

{
    "created_epoch": "1416441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416441600000",
    "number": "1154728160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7617 S CENTRAL AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85042",
            "telephone_number": "602-268-7076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7617 S CENTRAL AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850426513",
            "telephone_number": "602-268-7076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES B JAKOBSEN",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-20",
        "last_updated": "2014-11-20",
        "status": "A",
        "authorized_official_last_name": "WOOD",
        "authorized_official_first_name": "GINNY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "602-268-7076",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "AZ",
            "license": "6266",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "878671",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Albright Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dentist in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Dentist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2014; 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.