Julie Lynn Jacobs, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

55110 Issued in CA

Practice address

11670 Atwood Rd
Auburn, CA 95603-9522

Phone

(530) 887-2830

NPI assigned

Apr 4, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Dr. Julie Lynn Angellotti Former name

Medicare fee-for-service enrollment

Enrolled in CA

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

Practice roles

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

• Mokbil Dental Corporation

  • Dentist
  • Rancho Cordova, CA
  • NPI 1588185516
  NPD (past)
• Marana Health Center, Inc

  • Clinic Pharmacy
  • Tucson, AZ
  • NPI 1073072450
  NPD (past)

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708905600000",
    "number": "1861514432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11670 ATWOOD RD",
            "city": "AUBURN",
            "state": "CA",
            "postal_code": "956039522",
            "telephone_number": "310-220-5656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11670 ATWOOD RD",
            "city": "AUBURN",
            "state": "CA",
            "postal_code": "956039522",
            "telephone_number": "530-887-2830"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4022 Sunrise Blvd Ste 160",
            "address_purpose": "LOCATION",
            "city": "Rancho Cordova",
            "state": "CA",
            "postal_code": "957426908",
            "country_code": "US",
            "telephone_number": "916-246-1108",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13395 N Marana Main St",
            "address_purpose": "LOCATION",
            "city": "Marana",
            "state": "AZ",
            "postal_code": "856537008",
            "country_code": "US",
            "telephone_number": "520-616-6200",
            "fax_number": "520-682-1087",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "JULIE",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-04",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D0018181",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "55110",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "614291",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JULIE",
            "last_name": "ANGELLOTTI",
            "middle_name": "LYNN",
            "prefix": "DR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Teresa Isbell, DDS
• Jessica R Iverson, M.S., CCC-A
• Devin Jackson
• Joan Jackson, LMFT
• Kathryn Jackson, CADC-II
• Rebecca Marit Jacobson, MS CCC-SLP
• Tessa Jacques
• Vikram Jairam, M.D.
• Lars Jakob Jakobsen, M.D.
• James a. Willis MD Inc

• General Practice Dentistry in Auburn, CA
• Providers in Auburn, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2024; 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.