Jake Jacomet, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

8773 Issued in SC

Practice address

634B Fairview Rd
Simpsonville, SC 29680-6700

Phone

(864) 962-8767

NPI assigned

Apr 21, 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

State licenses

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

{
    "created_epoch": "1429574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551744000000",
    "number": "1528455268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 J MOORE AVE",
            "city": "TOWNVILLE",
            "state": "SC",
            "postal_code": "296893851",
            "telephone_number": "414-426-3532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "634B FAIRVIEW RD",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296806700",
            "telephone_number": "864-962-8767"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "S75W14088 Restfull Ln",
            "address_purpose": "LOCATION",
            "city": "Muskego",
            "state": "WI",
            "postal_code": "531503860",
            "country_code": "US",
            "telephone_number": "414-426-3532",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOMET",
        "first_name": "JAKE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-21",
        "last_updated": "2019-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "8773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Raymond Timothy Jackson, RPH
• Rebecca Elizabeth Jackson, DPT
• Savannah Leigh Jackson, OTR/L
• Sophia Jackson
• David C Jacobs, M.D.
• James F Richardson MD PA
• Joe E James
• Lisa G James, CRNA
• Marigrace James, MS, OTR/L
• Felicia Deloris Jamison

• General Practice Dentistry in Simpsonville, SC
• Providers in Simpsonville, SC by specialty
• General Practice Dentistry in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2019; 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.