Active NPI
Johanna M Jacobs, DDS
- Dentist
- New York, NY
National Provider Identifier
1548385131
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 048712
- Practice address
- 127 W 79TH St
Manhattan Dental Care
New York, NY 10024-6416 - Phone
- (212) 580-4790
- NPI assigned
- Mar 20, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 048712 | NY | Primary |
Addresses
Primary practice location
127 W 79TH St
Manhattan Dental Care
New York, NY 10024-6416
Mailing address
424 W End Ave
8H
New York, NY 10024-5760
Phone (212) 496-0136
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 048712 | NY | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Manhattan Dental Care | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Practice Dentistry
- New York, NY
- NPI 1083734644
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1548385131",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "424 W END AVE",
"address_2": "8H",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100245760",
"telephone_number": "212-496-0136"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "127 W 79TH ST",
"address_2": "MANHATTAN DENTAL CARE",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100246416",
"telephone_number": "212-580-4790"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOBS",
"first_name": "JOHANNA",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "048712",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.