Ghassan Elias Jacklis, D.M.D

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

11991 Issued in MD

Practice address

11125 Rockville Pike Ste 204
Rockville, MD 20852-3142

Phone

(301) 888-6666

NPI assigned

Mar 30, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 6, 2016 through Jan 6, 2028

Medicare enrollment (NPD)

Not enrolled

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 and National Provider Directory roles.

• Expert Advice LLC

  • Dental Clinic/Center
  • Rockville, MD
  • NPI 1558891119
  NPD (past) Authorized official

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

{
    "created_epoch": "1364601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525651200000",
    "number": "1659614410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11125 ROCKVILLE PIKE STE 204",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208523142",
            "telephone_number": "301-888-6666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11125 ROCKVILLE PIKE STE 204",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208523142",
            "telephone_number": "301-888-6666"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "44330 Premier Plz Ste 140",
            "address_purpose": "LOCATION",
            "city": "Ashburn",
            "state": "VA",
            "postal_code": "201475071",
            "country_code": "US",
            "telephone_number": "703-726-0333",
            "fax_number": "703-726-0553",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKLIS",
        "first_name": "GHASSAN",
        "middle_name": "ELIAS",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-03-30",
        "last_updated": "2018-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "DC",
            "license": "1001256",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "11991",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "0401413871",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "11991",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Payten Jablonski
• Ilana Jach
• Michael A Jach, M.D.
• Sianya Jacinto Rodriguez
• Joseph Jacklin
• Delijah Jacks
• Jazmin Jacks
• Jackson Clinics Limited Partnership
• Heather Anne Jackson-Pena, OTD, MOT, OTR/L, ETS
• Aijah Jackson

• General Practice Dentistry in Rockville, MD
• Providers in Rockville, MD by specialty
• General Practice Dentistry in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.