Richard Leslie Jacobson, D.M.D, M.S.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

DJ029308 Issued in CA

Practice address

881 Alma Real Dr
Suite 200
Pacific Palisades, CA 90272-3731

Phone

(310) 454-0317

Fax

(310) 459-3826

NPI assigned

Feb 27, 2007

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

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184751125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "881 ALMA REAL DR",
            "address_2": "SUITE 200",
            "city": "PACIFIC PALISADES",
            "state": "CA",
            "postal_code": "902723731",
            "telephone_number": "310-454-0317",
            "fax_number": "310-459-3826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "881 ALMA REAL DR",
            "address_2": "SUITE 200",
            "city": "PACIFIC PALISADES",
            "state": "CA",
            "postal_code": "902723731",
            "telephone_number": "310-454-0317",
            "fax_number": "310-459-3826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "RICHARD",
        "middle_name": "LESLIE",
        "name_prefix": "Dr.",
        "credential": "D.M.D, M.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "DJ029308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hayden Hunter
• Erin Lynne Imler, MD
• Gary Allan Jacob, DC
• Nina Karlin Jacob, MFT
• Tanya Jacob, PHD
• Frank Jasper, L.AC
• Richard A Johnson, MD
• Arielle Erin Jones
• K&a Psychological Services Inc
• Barbara Kagan, P.T.

• Orthodontics and Dentofacial Orthopedics Dentistry in Pacific Palisades, CA
• Providers in Pacific Palisades, CA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.