Jacob Caine Dachman, DMD

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

021.003272 Issued in IL

Practice address

4903 E State St
Rockford, IL 61108-2276

Phone

(815) 398-2323

NPI assigned

Apr 26, 2021

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

• Pediatric Dentistry of Northern Illinois LTD

  • Pediatric Dentistry
  • Rockford, IL
  • NPI 1376651679
  NPD (past)

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

{
    "created_epoch": "1619395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690848000000",
    "number": "1669054839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 LA QUINTA CT",
            "city": "LAKE IN THE HILLS",
            "state": "IL",
            "postal_code": "601564490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4903 E STATE ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611082276",
            "telephone_number": "815-398-2323"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3333 Burnet Ave",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452293026",
            "country_code": "US",
            "telephone_number": "815-236-7462",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5 La Quinta Ct",
            "address_purpose": "LOCATION",
            "city": "Lake IN The Hills",
            "state": "IL",
            "postal_code": "601564490",
            "country_code": "US",
            "telephone_number": "815-236-7462",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DACHMAN",
        "first_name": "JACOB",
        "middle_name": "CAINE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-26",
        "last_updated": "2023-08-01",
        "certification_date": "2023-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "IL",
            "license": "021.003272",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cyndie J Norton Professional Corporation
• Cynthia M. Sachs D.D.S., P.C.
• Gabrielle Czaja
• Michelle M. D'Almeida, DO
• Thomas Dace
• Nancy Gayle Dagefoerde, NP, APN
• Thomas K Dahlberg, DO
• Dahlia Center for Perinatal Mental Health PLLC
• Dahlia Center for Recovery, PLLC
• Renee J Dahm, NP

• Pediatric Dentistry in Rockford, IL
• Providers in Rockford, IL by specialty
• Pediatric Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2023; 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.