Douglas Jacobus, DDS, MD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

22DI02641300 Issued in NJ

Practice address

50 Division St Ste 301
Somerville, NJ 08876-2943

Phone

(908) 725-5585

NPI assigned

Mar 30, 2015

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

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1427673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620086400000",
    "number": "1427443282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 DIVISION ST STE 301",
            "city": "SOMERVILLE",
            "state": "NJ",
            "postal_code": "088762943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 DIVISION ST STE 301",
            "city": "SOMERVILLE",
            "state": "NJ",
            "postal_code": "088762943",
            "telephone_number": "908-725-5585"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 Bergen St",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "NJ",
            "postal_code": "071032495",
            "country_code": "US",
            "telephone_number": "973-972-3126",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOBUS",
        "first_name": "DOUGLAS",
        "credential": "DDS, MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-30",
        "last_updated": "2021-05-04",
        "certification_date": "2021-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NJ",
            "license": "22DI02641300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Judith Dale Iselin, RN APN-C CDE
• Jason Isenhour
• Zhanna Ivanov, M.D., M.S.
• J. Rowden Opticians Incorportated
• Kara M Jacobs, MD
• Jacqueline Stadler, LCSW, LLC
• Rubama Jahangir, APN
• Jason R Jannicelli, MS PAC
• Seher Javaid, MD
• Jay Ann Shop, Inc.

• Oral and Maxillofacial Surgery (Dentist) in Somerville, NJ
• Providers in Somerville, NJ by specialty
• Oral and Maxillofacial Surgery (Dentist) in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2021; 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.