Mack Jacob, DDS

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

MACK JACOB, DDS

Practice address

2012 Prince St
Berkeley, CA 94703-2519

Phone

(510) 843-8568

Fax

(510) 843-4448

NPI assigned

May 3, 2017

Organization subpart

No

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

Authorized official

Name

Marilyn Rodriquez

Title

Manager

Phone

(510) 843-8568

Specialties & licenses 1

Addresses

Practitioners 1

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

• Mack Jacob, DDS

  • Dentist
  • Berkeley, CA
  • NPI 1194845784
  NPD (past)

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

{
    "created_epoch": "1493769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493769600000",
    "number": "1730615329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2012 PRINCE ST",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947032519",
            "telephone_number": "510-843-8568",
            "fax_number": "510-843-4448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2012 PRINCE ST",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947032519",
            "telephone_number": "510-843-8568",
            "fax_number": "510-843-4448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MACK JACOB, DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-03",
        "last_updated": "2017-05-03",
        "status": "A",
        "authorized_official_last_name": "RODRIQUEZ",
        "authorized_official_first_name": "MARILYN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "510-843-8568"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maya Macgibbon
• Nicole Machado-Potestio
• Machaon Diagnostics, Inc.
• Mychal Verdad Macias
• Peter Macias
• Robert Thomas Mack, MD
• Robert DS Mackay, M.D.
• Christie Mackenzie, O.D.
• Erin Cafaro Mackenzie
• Onagh Wallace Mackenzie, MD

• Dentist in Berkeley, CA
• Providers in Berkeley, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2017; 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.