Jacob H McCullough, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

13453484-9921 Issued in UT

Practice address

8901 Wisconsin Ave Bethesda MD 20889
Bethesda, MD 20889-0001

Phone

(206) 697-1751

NPI assigned

Jul 14, 2023

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

Other names 1

• Dr. Jacob H McCullough Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• NH Camp Pendleton

  • Military General Acute Care Hospital
  • Camp Pendleton, CA
  • NPI 1386604387
  NPD (past)

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

{
    "created_epoch": "1689292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782086400000",
    "number": "1265111462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "WALTER REED NATIONAL MILITARY CTR 8901 WISCONSIN AVE",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208890001",
            "telephone_number": "301-295-0064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8901 WISCONSIN AVE BETHESDA MD 20889",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208890001",
            "telephone_number": "206-697-1751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCULLOUGH",
        "first_name": "JACOB",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-07-14",
        "last_updated": "2026-06-22",
        "certification_date": "2026-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "13453484-9921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACOB",
            "last_name": "MCCULLOUGH",
            "middle_name": "H",
            "prefix": "DR.",
            "credential": "DR",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Stephanie Aldridge McCorvey, MS, PT
• Gayle McCrossin, APRN FNP-BC
• Kathleen Frances McCue, DNP, CRNP, IBCLC
• Jill McCulloch, PHD
• Brendon McCullough, DO
• Markita McCurdy
• Patrick McCurdy, DDS
• David Hugh McDermott, MD
• Jennifer McDivitt, PT
• Ashton Reece McDonald, MD

• General Practice Dentistry in Bethesda, MD
• Providers in Bethesda, MD by specialty
• General Practice Dentistry in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2026; 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.