Active NPI
Jacob C. Daub, DDS, MS
- Orthodontics and Dentofacial Orthopedics Dentistry
- Germantown, WI
National Provider Identifier
1265616247
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 5821-015
- Practice address
- W172N9723 Division Rd
Suite B
Germantown, WI 53022-4603 - Phone
- (262) 255-1550
- NPI assigned
- Dec 26, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 5821-015 | WI | Primary |
Addresses
Primary practice location
W172N9723 Division Rd
Suite B
Germantown, WI 53022-4603
Mailing address
N99W14692 Twin Meadows Dr
Germantown, WI 53022-6612
Phone (414) 418-3786
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5821-015 | WI | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1198627200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1298592000000",
"number": "1265616247",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "N99W14692 TWIN MEADOWS DR",
"city": "GERMANTOWN",
"state": "WI",
"postal_code": "530226612",
"telephone_number": "414-418-3786"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "W172N9723 DIVISION RD",
"address_2": "SUITE B",
"city": "GERMANTOWN",
"state": "WI",
"postal_code": "530224603",
"telephone_number": "262-255-1550"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAUB",
"first_name": "JACOB",
"middle_name": "C.",
"credential": "DDS, MS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-12-26",
"last_updated": "2011-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "WI",
"license": "5821-015",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Germantown, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.