Jacob E Palma, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

043078 Issued in NY

Practice address

2200 Bergquist Dr Ste 1
Att: Credentials ( CMC)
Lackland a F B, TX 78236-9908

Phone

(210) 536-1846

Fax

(210) 536-3049

NPI assigned

Jul 4, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700816519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7011 HOLLY MOUNTAIN ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782503532",
            "telephone_number": "210-536-1846",
            "fax_number": "210-536-3049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 BERGQUIST DR STE 1",
            "address_2": "ATT: CREDENTIALS ( CMC)",
            "city": "LACKLAND A F B",
            "state": "TX",
            "postal_code": "782369908",
            "telephone_number": "210-536-1846",
            "fax_number": "210-536-3049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALMA",
        "first_name": "JACOB",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "043078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jose L Obregon, IDMT
• Craig Andrew Olson, MS, RD
• Geoffrey J Oravec, M.D.
• Edmund Osei-Wusu, PHARMD
• Michael Bernhard Osswald, M.D.
• Mark W Pape, PT
• Komalben Patel, PHARM .D.
• Emily Nell Pavlik, MD
• David Pedersen, M.S.
• William Brian Perry, MD

• General Practice Dentistry in Lackland a F B, TX
• Providers in Lackland a F B, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.