Carly Jacobs, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DS041967 Issued in PA

Practice address

1149 W Lancaster Ave Ste 5
Bryn Mawr, PA 19010-2722

Phone

(610) 851-4299

NPI assigned

Mar 4, 2016

Last updated

Jan 24, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Carly Smith Former name

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pain and Sleep Therapy Center LLC

  • Durable Medical Equipment & Medical Supplies
  • Bryn Mawr, PA
  • NPI 1144979485
  Authorized official Same address or phone
• Lalor Family Dental PLLC

  • General Practice Dentistry
  • Binghamton, NY
  • NPI 1366886632

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1457049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674518400000",
    "number": "1336509256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1149 W LANCASTER AVE STE 5",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190102722",
            "telephone_number": "610-851-4299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1149 W LANCASTER AVE STE 5",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190102722",
            "telephone_number": "610-851-4299"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "831 Haddon Ave",
            "address_purpose": "LOCATION",
            "city": "Collingswood",
            "state": "NJ",
            "postal_code": "081081923",
            "country_code": "US",
            "telephone_number": "856-854-5543",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "CARLY",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-04",
        "last_updated": "2023-01-24",
        "certification_date": "2023-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS041967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARLY",
            "last_name": "SMITH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Judith Lee Jabloner, M.D.
• Madelyn Jablonski
• Jack L. Martin, M.D., P.a.
• Tyler Jackson, MS, LAT, ATC
• Zita Elizabeth Jackson, DO
• Serena E.S. Jacobs, LCSW
• Heather Annette Jacoby, LCSW
• James H. Jacoby, M.D.
• Stephen C Jaffe, M.D.
• Lukasz Jakimiec, DO

• Dentist in Bryn Mawr, PA
• Providers in Bryn Mawr, PA by specialty
• Dentist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2023; 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.