Jacob Wassily

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

113763 Issued in CA

Practice address

2219 Belmont LN
Redondo Beach, CA 90278-5017

Phone

(310) 347-6976

NPI assigned

Aug 18, 2026

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

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

{
    "created_epoch": "1787011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787011200000",
    "number": "1497660765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2219 BELMONT LN",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902785017",
            "telephone_number": "310-347-6976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2219 BELMONT LN",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902785017",
            "telephone_number": "310-347-6976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASSILY",
        "first_name": "JACOB",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-08-18",
        "last_updated": "2026-08-18",
        "certification_date": "2026-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "113763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jillian Wang
• Shalonda Ward
• Jessica Warren, OTR/L
• Kai Washington
• Kelli Washington
• Nalani Watson, DC
• Toni Lechene Watson
• Lissa Watts
• Kerrie Weaver, M.F.T.
• Veronica Marie Webb, MA, OTR/L

• General Practice Dentistry in Redondo Beach, CA
• Providers in Redondo Beach, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2026; 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.