Jacob Woodrow Zellner, DMD, MS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

DN24083 Issued in FL

Practice address

2160 Capital Cir NE Ste 100
Tallahassee, FL 32308-4391

Phone

(850) 562-6111

Fax

(850) 562-7263

NPI assigned

Jun 24, 2019

Last updated

May 14, 2022By the provider in NPPES

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

Opted out of Medicare

Yes, effective May 29, 2024 through May 29, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Periodontal Associates of North Florida, PLLC

  • Dental Clinic/Center
  • Tallahassee, FL
  • NPI 1295245181
  NPD (past)

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

{
    "created_epoch": "1561334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652486400000",
    "number": "1538720222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2160 CAPITAL CIR NE STE 100",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084391",
            "telephone_number": "850-562-6111",
            "fax_number": "850-562-7263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 CAPITAL CIR NE STE 100",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084391",
            "telephone_number": "850-562-6111",
            "fax_number": "850-562-7263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZELLNER",
        "first_name": "JACOB",
        "middle_name": "WOODROW",
        "name_prefix": "Dr.",
        "credential": "DMD, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-24",
        "last_updated": "2022-05-14",
        "certification_date": "2022-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "FL",
            "license": "DN24083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon Zapata, COTA
• Christopher Zappi
• Dominick Zarcadoolas
• Amalia Zea, RBT
• Danielle R Zellner, SLPA
• Kathryn Zelsman
• Zenith Alchemy Inc (Jaguar Pharmacy)
• Zenith Care Inc (Wellpack Pharmacy)
• Zenith Remedies LLC (American Family Care)
• Jacquelyn Elizabeth Zetterower

• Periodontics in Tallahassee, FL
• Providers in Tallahassee, FL by specialty
• Periodontics in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.