NPIMap

Organization Active NPI

Jacob Wood Dental Corporation

  • Dentist
  • Paso Robles, CA
National Provider Identifier
1700534898
Registry record updated Mar 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
JACOB WOOD DENTAL CORPORATION
Practice address
502 First St Ste B
Paso Robles, CA 93446-3764
Phone
(805) 239-9597
Fax
(805) 239-4142
NPI assigned
Mar 17, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2022

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

Authorized official

Name
Jacob Alan Wood, DDSNPI 1588112247
Title
Owner, Ceo
Phone
(805) 540-9309

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary
Dental Clinic/Center 261QD0000X

Addresses

Primary practice location

502 First St Ste B
Paso Robles, CA 93446-3764

Mailing address

502 First St Ste B
Paso Robles, CA 93446-3764
Phone (805) 239-9597

Other names 1

  • Gateway Dental Practice Doing business as

National Provider Directory

National Provider Directory

Locations

502 First St
Ste B
Paso Robles, CA 93446
Phone (805) 239-9597

Practitioners & affiliated clinicians

Practitioners 4

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": "1647475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647734400000",
    "number": "1700534898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 FIRST ST STE B",
            "city": "PASO ROBLES",
            "state": "CA",
            "postal_code": "934463764",
            "telephone_number": "805-239-9597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 FIRST ST STE B",
            "city": "PASO ROBLES",
            "state": "CA",
            "postal_code": "934463764",
            "telephone_number": "805-239-9597",
            "fax_number": "805-239-4142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACOB WOOD DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-17",
        "last_updated": "2022-03-20",
        "certification_date": "2022-03-20",
        "status": "A",
        "authorized_official_last_name": "WOOD",
        "authorized_official_first_name": "JACOB",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "OWNER, CEO",
        "authorized_official_telephone_number": "805-540-9309",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gateway Dental Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Paso Robles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2022; 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.