Jose Carlos Jacas, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN24211 Issued in FL

Practice address

8108 N Nebraska Ave
Tampa, FL 33604-3103

Phone

(813) 866-0930

NPI assigned

Jun 20, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Sergio Jacas DMD LLC

  • Dentist
  • Lauderhill, FL
  • NPI 1831775816
  NPD (past)
• Supreme Dental Care LLC

  • Dental Clinic/Center
  • Tamarac, FL
  • NPI 1104522812
  NPD (past)

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

{
    "created_epoch": "1560988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565568000000",
    "number": "1669032603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 82969",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336822969",
            "telephone_number": "813-866-0930",
            "fax_number": "813-405-3722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8108 N NEBRASKA AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336043103",
            "telephone_number": "813-866-0930"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7000 W Oakland Park Blvd Ste 301",
            "address_purpose": "LOCATION",
            "city": "Lauderhill",
            "state": "FL",
            "postal_code": "333131016",
            "country_code": "US",
            "telephone_number": "954-742-3550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACAS",
        "first_name": "JOSE",
        "middle_name": "CARLOS",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-20",
        "last_updated": "2019-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN24211",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN24211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "josejacastampafamilyhealthcenters",
            "affiliation": "N",
            "address_1": "4620 N 22nd St",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "336106205",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• J.a.Santiago, Ms, RPT, P.a.
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• Jabber Jaw Kids Speech and Language Therapy, LLC
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• Jachimek Wellness Center
• Richard Henry Jachimek, DC
• Sergio J Jacinto, MD
• Jack B. Thigpen, III, DMD, PA

• General Practice Dentistry in Tampa, FL
• Providers in Tampa, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.