Leslie T Jacobs, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

1638 Issued in SC

Practice address

811 East Main Street
Spartanburg, SC 29302

Phone

(864) 573-9254

Fax

(864) 573-5416

NPI assigned

Aug 30, 2006

Sex

Male

Sole proprietor

Yes

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

Enrolled in NC

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

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891805677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 EAST MAIN STREET",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "29302",
            "telephone_number": "864-573-9254",
            "fax_number": "864-573-5416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 EAST MAIN STREET",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "29302",
            "telephone_number": "864-573-9254",
            "fax_number": "864-573-5416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "LESLIE",
        "middle_name": "T",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "1638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Jackson, CNA
• Kimberly R Jackson, LISW-CP
• Mary Jackson
• Michael Lee Jackson Jr., DO
• Elessa Jacobs, DC
• Shawn Jacobs, LAC
• Jaels Beauty LLC
• Asif Jafferani, M.D.
• James Dunn Surgical Clinic, LLC
• James J Jakubchak MD PA

• General Practice Dentistry in Spartanburg, SC
• Providers in Spartanburg, SC by specialty
• General Practice Dentistry in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.