Jacob Daniel Fugate, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12013924A Issued in IN

Practice address

1626 In-46
Terre Haute, IN 47803

Phone

(812) 877-2238

NPI assigned

Sep 2, 2022

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1662076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662076800000",
    "number": "1730809229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "152 CORINTH CT",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478039462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1626 IN-46",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "47803",
            "telephone_number": "812-877-2238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUGATE",
        "first_name": "JACOB",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-02",
        "last_updated": "2022-09-02",
        "certification_date": "2022-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12013924A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hannah M Freyberger, OCCUPATIONAL THERAPI
• Steven D Friday, O.D.
• Friendly Smiles Family Dentistry
• George R Fritch IV, MD
• Tara Fudger
• Lynn Fulford
• Brooke Fulk, RBT
• Kelli Lynne Fuller, B.S.
• Celinda Carol Fulling
• Melinda D Fuqua, NP

• All providers in Terre Haute, IN
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 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.