Active NPI
Leyvee Cabanilla Jacobs, DDS, MSD
- Periodontics
- Plymouth, MI
National Provider Identifier
1649374877
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 2901018271
- Practice address
- 40400 Ann Arbor Rd E
Ste 204a
Plymouth, MI 48170-6615 - Phone
- (734) 459-4077
- NPI assigned
- Sep 8, 2006
- Last updated
- Apr 11, 2014
- 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 |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 2901018271 | MI | Primary |
Addresses
Primary practice location
40400 Ann Arbor Rd E
Ste 204a
Plymouth, MI 48170-6615
Mailing address
40400 Ann Arbor Rd E
Ste 204a
Plymouth, MI 48170-6615
Phone (734) 459-4077
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 |
|---|---|---|---|
| 2901018271 | MI | MD | Periodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Periodontic PLLC | Periodontics | Past | Accepting new patients |
| Advanced Periodontics/Implantology | Periodontics | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Periodontics
- Plymouth, MI
- NPI 1972920478
-
- Periodontics
- Plymouth, MI
- NPI 1154619583
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157673600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1397174400000",
"number": "1649374877",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40400 ANN ARBOR RD E",
"address_2": "STE 204A",
"city": "PLYMOUTH",
"state": "MI",
"postal_code": "481706615",
"telephone_number": "734-459-4077"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "40400 ANN ARBOR RD E",
"address_2": "STE 204A",
"city": "PLYMOUTH",
"state": "MI",
"postal_code": "481706615",
"telephone_number": "734-459-4077"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOBS",
"first_name": "LEYVEE",
"middle_name": "CABANILLA",
"name_prefix": "Dr.",
"credential": "DDS, MSD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-08",
"last_updated": "2014-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "MI",
"license": "2901018271",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plymouth, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.