Alyssa Jacobs, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

2901601446 Issued in MI

Practice address

451 W Lincoln Ave
Madison Heights, MI 48071-3907

Phone

(248) 542-8001

NPI assigned

Jun 1, 2022

Last updated

Aug 12, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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  • NPI 1760263248
  NPD
• Michael L. Young DDS

  dba Forever Young Dentistry

  • General Practice Dentistry
  • Sterling Heights, MI
  • NPI 1578138806
  NPD
• Arch Dental PLLC

  • General Practice Dentistry
  • Madison Heights, MI
  • NPI 1124314430
  NPD (past)
• Khoury Dental PLLC

  dba Arch Dental

  • General Practice Dentistry
  • Madison Heights, MI
  • NPI 1134936131
  NPD (past)

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

{
    "created_epoch": "1654041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786492800000",
    "number": "1861131658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39242 DEQUINDRE RD STE 106",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483101767",
            "telephone_number": "586-795-5678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 W LINCOLN AVE",
            "city": "MADISON HEIGHTS",
            "state": "MI",
            "postal_code": "480713907",
            "telephone_number": "248-542-8001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "56074 Van Dyke Ave",
            "address_purpose": "LOCATION",
            "city": "Shelby Township",
            "state": "MI",
            "postal_code": "483165143",
            "country_code": "US",
            "telephone_number": "586-371-0245",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "53245 Hayes Rd",
            "address_purpose": "LOCATION",
            "city": "Shelby Township",
            "state": "MI",
            "postal_code": "483152110",
            "country_code": "US",
            "telephone_number": "586-488-2445",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "G3535 Beecher Rd Ste J",
            "address_purpose": "LOCATION",
            "city": "Flint",
            "state": "MI",
            "postal_code": "485322700",
            "country_code": "US",
            "telephone_number": "810-230-7483",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "ALYSSA",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-01",
        "last_updated": "2026-08-12",
        "certification_date": "2026-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901601446",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OH",
            "license": "RES.004489",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Jessica Johanna Janusch, MS, LLP, BCBA, LBA
• Anna Jaskulka, LMT

• Dentist in Madison Heights, MI
• Providers in Madison Heights, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2026; 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.