Active NPI
Nicholas Ross Jacobs, DMD, MS
- Prosthodontics
- Roseland, NJ
National Provider Identifier
1699449223
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- 22DI02855500
- Practice address
- 5 Becker Farm Rd Ste 101
Roseland, NJ 07068-1727 - Phone
- (862) 881-4139
- NPI assigned
- Aug 6, 2021
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | 22DI02855500 | NJ | Primary |
Addresses
Primary practice location
5 Becker Farm Rd Ste 101
Roseland, NJ 07068-1727
Mailing address
5 Becker Farm Rd Ste 101
Roseland, NJ 07068-1727
Other practice location 1
90 Woodbridge Center Dr Ste 300
Woodbridge, NJ 07095-1154
Phone (302) 540-1230
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | HopeRX |
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22DI02855500 | NJ | MD | Prosthodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1628208000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1628208000000",
"number": "1699449223",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5 BECKER FARM RD STE 101",
"city": "ROSELAND",
"state": "NJ",
"postal_code": "070681727"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5 BECKER FARM RD STE 101",
"city": "ROSELAND",
"state": "NJ",
"postal_code": "070681727",
"telephone_number": "862-881-4139"
}
],
"practiceLocations": [
{
"address_1": "90 Woodbridge Center Dr Ste 300",
"address_purpose": "LOCATION",
"city": "Woodbridge",
"state": "NJ",
"postal_code": "070951154",
"country_code": "US",
"telephone_number": "302-540-1230",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JACOBS",
"first_name": "NICHOLAS",
"middle_name": "ROSS",
"credential": "DMD, MS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-08-06",
"last_updated": "2021-08-06",
"certification_date": "2021-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0700X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist, Prosthodontics",
"state": "NJ",
"license": "22DI02855500",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "HopeRX",
"affiliation": "N",
"address_1": "5 Becker Farm Rd Ste 101",
"city": "Roseland",
"state": "NJ",
"country_code": "US",
"postal_code": "070681727",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Roseland, NJ
- Infiinihealth Ipa, LLC
- Infinisurg, LLC
- Inna Ioffe, MD
- J.P. Makhlouf M.D. F.a.Ap. Tiziana Anello M.D F.a.a.P P.a.
- Ira Jacobs, MD
- Kimberly Nicole Jaumot, MS, RD, LDN
- Jewish Service for the Developmentally Disabled of Metrowest, Inc.
- Jewish Service for the Developmentally Disabled of Metrowest, Inc.
- Jewish Service for the Developmentally Disabled of Metrowest, Inc.
- Jewish Service for the Developmentally Disabled of Metrowest, Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.