Jacob Rider DDS LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

JACOB RIDER DDS LLC

Practice address

2437 Harbor Blvd
Ventura, CA 93001-3904

Phone

(805) 804-5590

NPI assigned

Aug 16, 2024

Organization subpart

No

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

Authorized official

Name

Jacob RiderNPI 1467717546

Title

Owner Dentist

Phone

(317) 457-0338

Specialties & licenses 1

Addresses

Practitioners 1

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

• Jacob Ryan Rider, D.D.S.

  • General Practice Dentistry
  • Ventura, CA
  • NPI 1467717546
  NPD Authorized official

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

{
    "created_epoch": "1723766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723766400000",
    "number": "1316779432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 CEDAR PL",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930011920",
            "telephone_number": "317-457-0338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2437 HARBOR BLVD",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930013904",
            "telephone_number": "805-804-5590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACOB RIDER DDS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-16",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "status": "A",
        "authorized_official_last_name": "RIDER",
        "authorized_official_first_name": "JACOB",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "317-457-0338"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alex Jackson
• Brandi Denise Jackson
• Jeramie Jackson
• Mary Elizabeth Jackson, RN, LM
• Jacob Rider DDS Corporation (Pierpont Dental)
• Wendy Nicole Jacobo
• David Marc Jacobs
• James Owen Jacobs, DDS, MS
• Neil Jacobson, PT
• Aliya Natalie Jafar, PT, DPT

• General Practice Dentistry in Ventura, CA
• Providers in Ventura, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2024; 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.