NPIMap

Organization Active NPI

Dana R Jacques MD Inc

  • Gynecology Physician
  • Roseville, CA
National Provider Identifier
1700103249
Registry record updated Aug 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
G88578 Issued in CA
Legal business name
DANA R JACQUES MD INC
Practice address
1082 Sunrise Ave
Suite 190
Roseville, CA 95661-4302
Phone
(916) 788-2000
Fax
(916) 788-2010
NPI assigned
Apr 23, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2011

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

Authorized official

Name
Dr. Dana R Jacques, M.D.
Title
President
Phone
(916) 788-2000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207VG0400X G88578 CA Primary

Addresses

Primary practice location

1082 Sunrise Ave
Suite 190
Roseville, CA 95661-4302

Mailing address

1082 Sunrise Ave
Suite 190
Roseville, CA 95661-4302
Phone (916) 788-2000

National Provider Directory

National Provider Directory

Locations

2110 Professional Dr
Ste 105
Roseville, CA 95661
Phone (916) 536-2500

Practitioners & affiliated clinicians

Practitioners 3

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": "1271980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312848000000",
    "number": "1700103249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1082 SUNRISE AVE",
            "address_2": "SUITE 190",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956614302",
            "telephone_number": "916-788-2000",
            "fax_number": "916-788-2010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1082 SUNRISE AVE",
            "address_2": "SUITE 190",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956614302",
            "telephone_number": "916-788-2000",
            "fax_number": "916-788-2010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DANA R JACQUES MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-23",
        "last_updated": "2011-08-09",
        "status": "A",
        "authorized_official_last_name": "JACQUES",
        "authorized_official_first_name": "DANA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "916-788-2000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "CA",
            "license": "G88578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2011; 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.