Hari Jacob, DDS
Individual provider Active NPI Dentist · Kerman, CA
NPI 1255432191 · NPPES record last updated Jul 14, 2014
Key facts
- NPI
- 1255432191
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 42793 (CA)
- Practice address
- 184 S Madera Ave
Kerman, CA 93630 - Phone
- (559) 846-3333
- Fax
- (559) 846-8999
- NPI assigned
- Sep 25, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 42793 | CA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| R & N Panchal Dental Group, a Professional Dental Corporation | Past |
Accepting new patients |
Interoperability endpoints
- hari.jacob.p1@direct.altura.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 42793 | CA | Yes |
Addresses
Primary practice location
184 S Madera Ave
Kerman, CA 93630
Mailing address
184 S Madera Ave
Kerman, CA 93630
Phone (559) 846-3333
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| G92271 | Other | CA | DENTICAL |
Other providers in Kerman, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 14, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.