NPIMap

Organization Active NPI

Jacob Dent DDS. Metairie Modern Dentistry a Professional Corporation

  • Dentist
  • Metairie, LA
National Provider Identifier
1487106910
Registry record updated Nov 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
JACOB DENT DDS. METAIRIE MODERN DENTISTRY A PROFESSIONAL CORPORATION
Practice address
2937 Veterans Memorial Blvd, Ste C
Metairie, LA 70002
Phone
(504) 206-3338
Fax
(504) 208-3647
NPI assigned
Nov 1, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jacob Dent, DDS
Title
Owner
Phone
504201633388

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

2937 Veterans Memorial Blvd, Ste C
Metairie, LA 70002

Mailing address

17000 Red Hill Ave
Irvine, CA 92614-5626
Phone (714) 845-8850

Other names 1

  • Metairie Modern Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

2937 Veterans Memorial Blvd
Ste C
Metairie, LA 70002
Phone (504) 206-3338

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1477958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477958400000",
    "number": "1487106910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17000 RED HILL AVE",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926145626",
            "telephone_number": "714-845-8850",
            "fax_number": "949-474-1495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2937 VETERANS MEMORIAL BLVD, STE C",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "70002",
            "telephone_number": "504-206-3338",
            "fax_number": "504-208-3647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACOB DENT DDS. METAIRIE MODERN DENTISTRY A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-01",
        "last_updated": "2016-11-01",
        "status": "A",
        "authorized_official_last_name": "DENT",
        "authorized_official_first_name": "JACOB",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "504201633388",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Metairie Modern Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Metairie, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 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.