Jacob Storer, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7552 Issued in OK

Practice address

103 S Broadway St
Cleveland, OK 74020-4614

Phone

(918) 358-0002

NPI assigned

May 10, 2022

Last updated

May 10, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Locations

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

• Trailhead Dental

  • Dental Clinic/Center
  • Spokane, WA
  • NPI 1548119720
  NPD Authorized official
• Spring Dental Cleveland, PLLC

  • Dental Clinic/Center
  • Cleveland, OK
  • NPI 1295376309
  NPD
• Cleveland Dental Inc.

  • Dental Clinic/Center
  • Cleveland, OK
  • NPI 1952547671
  NPD (past)
• Okc Dental Health Associates, P.C.

  dba Lakeview Pointe Dentistry

  • General Practice Dentistry
  • Stillwater, OK
  • NPI 1306266259
  NPD (past)
• Summer Dental Stillwater, PLLC

  dba Lakeview Pointe Dentistry

  • Dental Clinic/Center
  • Stillwater, OK
  • NPI 1427669936
  NPD (past)

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

{
    "created_epoch": "1652140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652140800000",
    "number": "1306582531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 RIVERWALK TER STE 250",
            "city": "JENKS",
            "state": "OK",
            "postal_code": "740375619",
            "telephone_number": "918-998-0996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 S BROADWAY ST",
            "city": "CLEVELAND",
            "state": "OK",
            "postal_code": "740204614",
            "telephone_number": "918-358-0002"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2200 N Perkins Rd",
            "address_purpose": "LOCATION",
            "city": "Stillwater",
            "state": "OK",
            "postal_code": "740753076",
            "country_code": "US",
            "telephone_number": "405-372-7051",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STORER",
        "first_name": "JACOB",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-10",
        "last_updated": "2022-05-10",
        "certification_date": "2022-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OK",
            "license": "7552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Bernadette Smith, LMHC
• Lee Southard
• Michelle Spears
• Spring Dental Cleveland, PLLC
• Kelly Steed
• Sunbeam Healthcare LLC
• Sunbeam Home Healthcare, LLC
• Sweet Town, LLC (Cleveland Manor Nursing Home)
• Taf Ancillary Medical Services Co
• Catherine Tarrant, DPT

• General Practice Dentistry in Cleveland, OK
• Providers in Cleveland, OK by specialty
• General Practice Dentistry in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2022; 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.