Benjamin Harrison Jacobs, DMD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

053451-1 Issued in NY

Practice address

10 Amsterdam Ave
Apt 406
New York, NY 10023-7464

Phone

(908) 591-9646

NPI assigned

Jul 30, 2008

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

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1217376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217376000000",
    "number": "1164688115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 AMSTERDAM AVE",
            "address_2": "APT 406",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100237464",
            "telephone_number": "908-591-9646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 AMSTERDAM AVE",
            "address_2": "APT 406",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100237464",
            "telephone_number": "908-591-9646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "BENJAMIN",
        "middle_name": "HARRISON",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-30",
        "last_updated": "2008-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "053451-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Akiva Jacobs
• Alan Roy Jacobs, M.D.
• Alysha Jacobs
• Anke Vera Jacobs, M.D.
• Arielle Chassen Jacobs, DMD
• Carl Jacobs, LP D.SC.
• Christina Jacobs, PMHNP
• Damon Lance Jacobs, LMFT
• Daniel Jacobs, MD
• Daniel Li-Ming Jacobs, MD

• Oral and Maxillofacial Surgery (Dentist) in New York, NY
• Providers in New York, NY by specialty
• Oral and Maxillofacial Surgery (Dentist) in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.