John Robert Jaicks, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DT-3135 Issued in HI

Practice address

590 Farrington Hwy Unit 523
Kapolei, HI 96707-2034

Phone

(808) 674-9988

NPI assigned

Jun 6, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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 and National Provider Directory roles.

• Jaicks DMD PLLC

  • Dental Clinic/Center
  • Altamonte Springs, FL
  • NPI 1114859014
  NPD Authorized official
• Dental World Kapolei, LLC

  • Dental Clinic/Center
  • Kapolei, HI
  • NPI 1295240968
  NPD (past)

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

{
    "created_epoch": "1622937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704758400000",
    "number": "1508433822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "590 FARRINGTON HWY UNIT 523",
            "city": "KAPOLEI",
            "state": "HI",
            "postal_code": "967072034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "590 FARRINGTON HWY UNIT 523",
            "city": "KAPOLEI",
            "state": "HI",
            "postal_code": "967072034",
            "telephone_number": "808-674-9988"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "153 W Main St Ste 101",
            "address_purpose": "LOCATION",
            "city": "New Albany",
            "state": "OH",
            "postal_code": "430549225",
            "country_code": "US",
            "telephone_number": "614-741-7031",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAICKS",
        "first_name": "JOHN",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-06",
        "last_updated": "2024-01-09",
        "certification_date": "2024-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.026526",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "HI",
            "license": "DT-3135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://mainstreetdentalnewalbany.com/contact/",
            "affiliation": "N",
            "address_1": "153 W Main St Ste 101",
            "city": "New Albany",
            "state": "OH",
            "country_code": "US",
            "postal_code": "430549225",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jennifer S Iyo, DPT
• Mattix Jaccaud
• Robert E Jackson, PH.D.
• Jaco Rehab Kapolei Limited Partnership
• Jaco Rehab Kapolei, LLC
• Michelle Nicole Indig Janeo, LMFT
• Jaewon Jang
• Sandara Lair Gaoiran Jaralba
• Kayla E Jarossy
• Zsazare Jasmin

• Dentist in Kapolei, HI
• Providers in Kapolei, HI by specialty
• Dentist in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2024; 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.