Amanda Jacobs, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3804-15 Issued in MS

Practice address

411 Willis St
Taylorsville, MS 39168-4550

Phone

(601) 785-4770

NPI assigned

Jun 19, 2015

Last updated

Jun 19, 2015By the provider in NPPES

Sex

Female

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

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.

• Dental Professionals of Mississippi, P.C.

  dba Taylorsville Dental Care

  • Dentist
  • Taylorsville, MS
  • NPI 1205011608
  NPD (past)

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

{
    "created_epoch": "1434672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434672000000",
    "number": "1407238090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 WILLIS ST",
            "city": "TAYLORSVILLE",
            "state": "MS",
            "postal_code": "391684550",
            "telephone_number": "601-785-4770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 WILLIS ST",
            "city": "TAYLORSVILLE",
            "state": "MS",
            "postal_code": "391684550",
            "telephone_number": "601-785-4770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "AMANDA",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-19",
        "last_updated": "2015-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MS",
            "license": "3804-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chante Nicole Ferguson
• Freds Xpress (Freds Stores of Tennessee Inc)
• John R. Harper, MD
• Hattiesburg Clinic PA (Taylorsville Medical Clinic)
• Lynwood Hightower
• JFMC Taylorsville, LLC
• John R. Harper,MD, PA
• Vera Denise Kennedy-Miller, LMT#392 MASSAGE THEP
• Magee Benevolent Association (John R Harper, MD)
• Mississippi Medical Clinic

• General Practice Dentistry in Taylorsville, MS
• Providers in Taylorsville, MS by specialty
• General Practice Dentistry in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2015; 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.