Jaycob Walter Enzler, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE61165833 Issued in WA

Practice address

100 N Mullan Rd Ste 204
Spokane Valley, WA 99206-6848

Phone

(509) 998-4241

NPI assigned

Jun 28, 2019

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

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.

• Bridging the Dental Gap Inc

  • Dental Clinic/Center
  • Bismarck, ND
  • NPI 1649338377
  NPD (past)

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

{
    "created_epoch": "1561680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746403200000",
    "number": "1285296319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17506 E 13TH AVE",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "990167506",
            "telephone_number": "509-998-4241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N MULLAN RD STE 204",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992066848",
            "telephone_number": "509-998-4241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENZLER",
        "first_name": "JAYCOB",
        "middle_name": "WALTER",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-06-28",
        "last_updated": "2025-05-05",
        "certification_date": "2025-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE61165833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keisha Engley, RD
• Susan Therese English, LMHC
• Karly Engstrom, PTA
• Sarah Christine Ennis, RN
• Krystin Michelle Ensign
• Justyn Epps
• Eric C Ellingsen DDS PS
• Eric C Ellingsen DDS PS
• Eric Ellingsen DDS, PS
• Jamie Marie Erickson, LMP

• General Practice Dentistry in Spokane Valley, WA
• Providers in Spokane Valley, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2025; 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.