Jae Dental PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

24381 Issued in TX

Legal business name

JAE DENTAL PLLC

Practice address

201 S Rogers Rd
Irving, TX 75060-2608

Phone

(817) 710-7443

Fax

(817) 710-1447

NPI assigned

Aug 16, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Jason Troy Bacon, D.D.S.NPI 1336394568

Title

Owner

Phone

(817) 710-7443

Specialties & licenses 1

Addresses

Practitioners 2

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

• Jason T Bacon, DDS

  • General Practice Dentistry
  • Irving, TX
  • NPI 1336394568
  NPD (past) Authorized official
• Emily Sue Danner, D.D.S.

  • Dentist
  • Fort Worth, TX
  • NPI 1275949018
  NPD (past)

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

{
    "created_epoch": "1471305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471305600000",
    "number": "1265987598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6726 CAMP BOWIE BLVD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761167113",
            "telephone_number": "817-710-7443",
            "fax_number": "817-710-7447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 S ROGERS RD",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750602608",
            "telephone_number": "817-710-7443",
            "fax_number": "817-710-1447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAE DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-16",
        "last_updated": "2016-08-16",
        "status": "A",
        "authorized_official_last_name": "BACON",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "TROY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-710-7443",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "24381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacob Pediatrics PLLC
• Jais Mathew Jacob, MSN, RN, FNP-C
• Jeswin Chamathil Jacob
• Kusumam Jacob, RN
• Diana Lizbeht Jacobo, SLPA
• Ramin Reza Jafari, DDS
• Iffat Jahan, MD
• Jaime L. Gonzalez, D.C,P.a
• Joanna Brygida Jakubowska, COTA
• Ebyan Omar Jamal

• General Practice Dentistry in Irving, TX
• Providers in Irving, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2016; 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.