NPIMap

Organization Active NPI

Jacob D Groom DMD PLLC

  • General Practice Dentistry
  • Vancouver, WA
National Provider Identifier
1699560300
Registry record updated Mar 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
JACOB D GROOM DMD PLLC
Doing business as
Hiddenbrook Dental
Practice address
19111 SE 34TH St Ste 104
Vancouver, WA 98683-1449
Phone
(360) 823-0427
NPI assigned
Apr 12, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2026

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

Authorized official

Name
Jacob GroomNPI 1902476682
Title
Member
Phone
(503) 702-6532

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

19111 SE 34TH St Ste 104
Vancouver, WA 98683-1449

Mailing address

19111 SE 34TH St Ste 104
Vancouver, WA 98683-1449
Phone (360) 823-0427

Other names 1

  • Hiddenbrook Dental Doing business as

National Provider Directory

National Provider Directory

Locations

19111 SE 34th St
Ste 104
Vancouver, WA 98683
Phone (360) 823-0427

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1744416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773792000000",
    "number": "1699560300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19111 SE 34TH ST STE 104",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986831449",
            "telephone_number": "360-823-0427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19111 SE 34TH ST STE 104",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986831449",
            "telephone_number": "360-823-0427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACOB D GROOM DMD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-12",
        "last_updated": "2026-03-18",
        "certification_date": "2026-03-18",
        "status": "A",
        "authorized_official_last_name": "GROOM",
        "authorized_official_first_name": "JACOB",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "503-702-6532"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hiddenbrook Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2026; 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.