NPIMap

Organization Active NPI

Pablo Jacobo DDS Inc

  • Dentist
  • Stockton, CA
National Provider Identifier
1235500455
Registry record updated Oct 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
38433 Issued in CA
Legal business name
PABLO JACOBO DDS INC
Practice address
1035 W Robinhood Dr
Stockton, CA 95207-5621
Phone
(209) 952-3687
Fax
(209) 952-6267
NPI assigned
Oct 14, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2015

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

Authorized official

Name
Mr. Carlos Jacobo
Title
Manager
Phone
(209) 952-3687

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 38433 CA Primary
Oral and Maxillofacial Surgery (Dentist)Group: 193200000X MULTI-SPECIALTY GROUP 1223S0112X 60242 CA

Addresses

Primary practice location

1035 W Robinhood Dr
Stockton, CA 95207-5621

Mailing address

1035 W Robinhood Dr
200
Stockton, CA 95207-5621
Phone (209) 952-3687

Other names 1

  • Gotta Smile Dentistry Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Gotta Smile Dentistry2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

1035 W Robinhood Dr
Ste 200
Stockton, CA 95207
Phone (209) 952-3687

1035 W Robinhood Dr
Stockton, CA 95207
Phone (209) 952-3687

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1444780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444780800000",
    "number": "1235500455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1035 W ROBINHOOD DR",
            "address_2": "200",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952075621",
            "telephone_number": "209-952-3687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 W ROBINHOOD DR",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952075621",
            "telephone_number": "209-952-3687",
            "fax_number": "209-952-6267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PABLO JACOBO DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-14",
        "last_updated": "2015-10-14",
        "status": "A",
        "authorized_official_last_name": "JACOBO",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "209-952-3687",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "38433",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "60242",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gotta Smile Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stockton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2015; 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.