Jacob Charles McInnis, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6278 Issued in LA

Practice address

1305 W Esplanade Ave
Kenner, LA 70065-2744

Phone

(504) 469-6333

Fax

(504) 469-6355

NPI assigned

Jun 19, 2012

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

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.

• Exceptional Dental of Metairie, LLC

  • General Practice Dentistry
  • Metairie, LA
  • NPI 1326575945
  NPD (past)
• Exceptional Dental of Mid City LLC

  • General Practice Dentistry
  • New Orleans, LA
  • NPI 1386019909
  NPD (past)
• Exceptional Dental of Slidell

  • General Practice Dentistry
  • Slidell, LA
  • NPI 1609228428
  NPD (past)
• Exceptional Dental of Watson, LLC

  • Dentist
  • Denham Springs, LA
  • NPI 1982180279
  NPD (past)

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

{
    "created_epoch": "1340064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616457600000",
    "number": "1881957421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 W ESPLANADE AVE",
            "city": "KENNER",
            "state": "LA",
            "postal_code": "700652744",
            "telephone_number": "504-463-6333",
            "fax_number": "504-469-6355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 W ESPLANADE AVE",
            "city": "KENNER",
            "state": "LA",
            "postal_code": "700652744",
            "telephone_number": "504-469-6333",
            "fax_number": "504-469-6355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINNIS",
        "first_name": "JACOB",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-19",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "6278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John P McCrossen, M.D.
• Jamie Mitchell McDonald, APRN
• Achontyrausi B McFarland, CRNA
• Tamiko McGee, BA
• Dylan J McGovern
• De'Lise Marie McKay, PMHNP
• Kelisia Burks McKay, FNP
• Chris McKeown, D.C.
• Tara McKnight
• Chelsey McMillon, PHARM.D.

• General Practice Dentistry in Kenner, LA
• Providers in Kenner, LA by specialty
• General Practice Dentistry in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2021; 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.