Jacob Long, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

10411 Issued in NC

Practice address

1611 Greenfield St
Wilmington, NC 28401-6455

Phone

(910) 342-9210

NPI assigned

May 4, 2016

Last updated

Jul 13, 2016By 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.

• Jrlong, PLLC

  dba The Dental Studio

  • Clinic/Center
  • Wilmington, NC
  • NPI 1184392300
  NPD Authorized official

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

{
    "created_epoch": "1462320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468368000000",
    "number": "1407201809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 GREENFIELD ST",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284016455",
            "telephone_number": "910-342-9210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 GREENFIELD ST",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284016455",
            "telephone_number": "910-342-9210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "JACOB",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-04",
        "last_updated": "2016-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "10411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carla London, MSW, LCSW-A
• Lauren Lonergan, PMHNP-BC
• Caitlin Long, DPT, CKTP
• Elizabeth Holland Long, MS ED
• Erin Brooke Long, BSW
• Jody Long, LPA, LCAS, CCS
• Katherine R Longbottom, RD-LDN, IBCLC
• Kim K Longbottom, LCSW, LCAS
• Alyssa Longenecker, PHARMD
• Jeffrey John Longman, DC

• General Practice Dentistry in Wilmington, NC
• Providers in Wilmington, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.