Gina Mira Jacobsen, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

019-027370 Issued in IL

Practice address

1940 W Galena Blvd
Suite 10
Aurora, IL 60506-4319

Phone

(630) 892-8933

NPI assigned

Jun 27, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Gina Mira Sbalchiero Former name

Medicare fee-for-service enrollment

Enrolled in IL

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": "1182902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216684800000",
    "number": "1790982502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1940 W GALENA BLVD",
            "address_2": "SUITE 10",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605064319",
            "telephone_number": "630-892-8933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1940 W GALENA BLVD",
            "address_2": "SUITE 10",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605064319",
            "telephone_number": "630-892-8933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSEN",
        "first_name": "GINA",
        "middle_name": "MIRA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-27",
        "last_updated": "2008-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019-027370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GINA",
            "last_name": "SBALCHIERO",
            "middle_name": "MIRA",
            "prefix": "DR.",
            "credential": "D.D.S.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Abdulah Jabri, DMD
• Sangmesh Jabshetty, M.D.
• Shamika Jackson
• Roslin Jacob, PT
• Jamil Jacobs-El, MD
• Alan C Jacobson, MD
• Luke M. Jacobson, DPT
• Faryal Jafar, MD
• Syed Ali Jafrey
• Mohamed Jalloh, BA

• Dentist in Aurora, IL
• Providers in Aurora, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2008; 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.