NPIMap

Organization Active NPI

Stephen E Jacobson DDS PC

Doing business as Jacobson Dental Group

  • General Practice Dentistry
  • Commerce Township, MI
National Provider Identifier
1518117498
Registry record updated Jul 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
14257 Issued in MI
Legal business name
STEPHEN E JACOBSON DDS PC
Doing business as
Jacobson Dental Group
Practice address
39890 W 14 Mile Rd
Commerce Township, MI 48390-3911
Phone
(248) 624-8090
Fax
(248) 624-8288
NPI assigned
Sep 26, 2008
Last updated
Jul 28, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2022

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

Authorized official

Name
Dr. Stephen E Jacobson, D.D.S, P.C.NPI 1528077435
Title
Dentist
Phone
(248) 624-8090

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 18553 MI
General Practice Dentistry 1223G0001X 16758 MI
General Practice Dentistry 1223G0001X 14257 MI Primary
Periodontics 1223P0300X 18913 MI

Addresses

Primary practice location

39890 W 14 Mile Rd
Commerce Township, MI 48390-3911

Mailing address

39890 W 14 Mile Rd
Walled Lake, MI 48390-3911
Phone (248) 624-8090

Other names 1

  • Jacobson Dental Group Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1222387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658966400000",
    "number": "1518117498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39890 W 14 MILE RD",
            "city": "WALLED LAKE",
            "state": "MI",
            "postal_code": "483903911",
            "telephone_number": "248-624-8090",
            "fax_number": "248-624-8288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39890 W 14 MILE RD",
            "city": "COMMERCE TOWNSHIP",
            "state": "MI",
            "postal_code": "483903911",
            "telephone_number": "248-624-8090",
            "fax_number": "248-624-8288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHEN E JACOBSON DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-26",
        "last_updated": "2022-07-28",
        "certification_date": "2022-06-07",
        "status": "A",
        "authorized_official_last_name": "JACOBSON",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "248-624-8090",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S, P.C."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "18553",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "16758",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "14257",
            "primary": true
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "MI",
            "license": "18913",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jacobson Dental Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Jacobson Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Commerce Township, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2022; 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.