NPIMap

Organization Active NPI

Jacobson Dental Corp

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Vallejo, CA
National Provider Identifier
1598568263
Registry record updated Mar 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
JACOBSON DENTAL CORP
Practice address
932 Admiral Callaghan LN
Vallejo, CA 94591-3680
Phone
(707) 794-2020
Fax
(844) 534-8464
NPI assigned
Mar 28, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2025

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

Authorized official

Name
Kushboo Kumar
Title
Credentialing Specialist
Phone
(916) 877-7450

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223X0400X Primary

Addresses

Primary practice location

932 Admiral Callaghan LN
Vallejo, CA 94591-3680

Mailing address

1420 Rocky Ridge Dr Ste 320
Roseville, CA 95661-2835
Phone (916) 877-7450

Other names 1

  • Children's Choice Dental Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dr Jeffrey a Saladin Dental Corporation30 organizations share this tax ID, including this one

Other organizations with this tax ID 29

Organizations that report the same tax identification number in the National Provider Directory.

View all 29

Locations

932 Admiral Callaghan Ln
Vallejo, CA 94591
Phone (707) 794-2020

NPI Registry JSON

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

{
    "created_epoch": "1743120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743120000000",
    "number": "1598568263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 ROCKY RIDGE DR STE 320",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956612835",
            "telephone_number": "916-877-7450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "932 ADMIRAL CALLAGHAN LN",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945913680",
            "telephone_number": "707-794-2020",
            "fax_number": "844-534-8464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACOBSON DENTAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-28",
        "last_updated": "2025-03-28",
        "certification_date": "2025-03-11",
        "status": "A",
        "authorized_official_last_name": "KUMAR",
        "authorized_official_first_name": "KUSHBOO",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "916-877-7450"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Children's Choice Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vallejo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2025; 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.