Jacob Edward Coffey, D.M.D

Primary specialty

DentistTaxonomy code 122300000X

License

2016029131 Issued in MO

Practice address

1491 E 10TH St
Rolla, MO 65401-3996

Phone

(573) 364-2868

NPI assigned

Aug 12, 2016

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)

Enrolled

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

{
    "created_epoch": "1470960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470960000000",
    "number": "1396299863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "690 DONALD DR",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654014803",
            "telephone_number": "217-827-8033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1491 E 10TH ST",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654013996",
            "telephone_number": "573-364-2868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COFFEY",
        "first_name": "JACOB",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-12",
        "last_updated": "2016-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2016029131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brett Benson Clayton, PA-C
• Clear Water Therapy
• Kathi D. Clement, MD
• Clinical Research of the Ozarks, Inc.
• Sellas Pecos Coble, D.O.
• Jeffrey M Cohen, LPC
• Aaron Cohlmia, CNP
• James H Colench, CRNA
• Jeffrey Colench, CRNA
• Tiffany Lynn Colletta, MSW, LCSW

• Dentist in Rolla, MO
• Providers in Rolla, MO by specialty
• Dentist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2016; 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.