NPIMap

Organization Active NPI

Jacob R Diebold, DDS, LLC

  • Dental Clinic/Center
  • Saint Francisville, LA
National Provider Identifier
1902286941
Registry record updated Jun 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
6554 Issued in LA
Legal business name
JACOB R DIEBOLD, DDS, LLC
Practice address
7181 US Highway 61
St. Francisville, LA 70775
Phone
(225) 635-4707
Fax
(225) 635-2172
NPI assigned
Jun 4, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2015

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

Authorized official

Name
Jacob Ryan Diebold, D.D.SNPI 1992187389
Title
Managing Member
Phone
(318) 614-3273

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 6554 LA Primary

Addresses

Primary practice location

7181 US Highway 61
St. Francisville, LA 70775

Mailing address

PO Box 1068
Saint Francisville, LA 70775-1068
Phone (225) 635-4707

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1433376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433376000000",
    "number": "1902286941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1068",
            "city": "SAINT FRANCISVILLE",
            "state": "LA",
            "postal_code": "707751068",
            "telephone_number": "225-635-4707",
            "fax_number": "225-635-2172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7181 US HIGHWAY 61",
            "city": "ST. FRANCISVILLE",
            "state": "LA",
            "postal_code": "70775",
            "telephone_number": "225-635-4707",
            "fax_number": "225-635-2172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACOB R DIEBOLD, DDS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-04",
        "last_updated": "2015-06-04",
        "status": "A",
        "authorized_official_last_name": "DIEBOLD",
        "authorized_official_first_name": "JACOB",
        "authorized_official_middle_name": "RYAN",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "318-614-3273",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "LA",
            "license": "6554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Francisville, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2015; 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.