Jacob Mark Judy, D.D.S.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

30.024454 Issued in OH

Practice address

3555 Cliffhanger Way
Zanesville, OH 43701

Phone

(740) 450-3636

NPI assigned

May 21, 2015

Last updated

Aug 25, 2018By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1432166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535155200000",
    "number": "1346629516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3555 CLIFFHANGER WAY",
            "city": "ZANESVILLE",
            "state": "OH",
            "postal_code": "437016420",
            "telephone_number": "740-450-3636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3555 CLIFFHANGER WAY",
            "city": "ZANESVILLE",
            "state": "OH",
            "postal_code": "43701",
            "telephone_number": "740-450-3636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUDY",
        "first_name": "JACOB",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-21",
        "last_updated": "2018-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.024454",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "OH",
            "license": "30.024454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Endodontics in Zanesville, OH
• Providers in Zanesville, OH by specialty
• Endodontics in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.