Jerrold T. Jacob D.M.D., P.a.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

JERROLD T. JACOB D.M.D., P.A.

Doing business as

Family Dental Group

Practice address

484 Washington Ave
Belleville, NJ 07109-2688

Phone

(973) 759-1010

Fax

(973) 759-2411

NPI assigned

Apr 4, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Jerrold Ted Jacob, D.M.D.

Title

President

Phone

(973) 759-1010

Specialties & licenses 1

Addresses

Other names 1

• Family Dental Group Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Alan Todd Jacob, D.M.D.

  • General Practice Dentistry
  • Belleville, NJ
  • NPI 1215255005
  NPD (past)

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1699897009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "484 WASHINGTON AVE",
            "city": "BELLEVILLE",
            "state": "NJ",
            "postal_code": "071092688",
            "telephone_number": "973-759-1010",
            "fax_number": "973-759-2411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "484 WASHINGTON AVE",
            "city": "BELLEVILLE",
            "state": "NJ",
            "postal_code": "071092688",
            "telephone_number": "973-759-1010",
            "fax_number": "973-759-2411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERROLD T. JACOB D.M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JACOB",
        "authorized_official_first_name": "JERROLD",
        "authorized_official_middle_name": "TED",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "973-759-1010",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "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": "Family Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kedar Jani, PA-C
• Emily Geneva Jaroslawski, PA-C
• Roy Anthony Ngpit Javier, CRNA
• Betsy Jean-Louis, FNP-BC, APN-C
• Dania Jean-Louis, APN
• Jersey Rehab PA
• Jersey Rehab PA
• Joel John
• Donya Paulette Johnson, LPC
• Lisa M. Johnson, L.C.S.W.

• General Practice Dentistry in Belleville, NJ
• Providers in Belleville, NJ by specialty
• General Practice Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.