Jacob Sheppard, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401414898 Issued in VA

Practice address

210 N 4TH Ave
Hopewell, VA 23860-2504

Phone

(804) 458-3004

Fax

(804) 458-3056

NPI assigned

Jun 17, 2015

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

Enrolled in VA

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

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.

• Sycamore Family Dentistry

  • General Practice Dentistry
  • Midlothian, VA
  • NPI 1609520535
  NPD Authorized official
• Hopewell Family Dentistry, PC

  • General Practice Dentistry
  • Hopewell, VA
  • NPI 1730687526
  NPD (past) Authorized official
• Powhatan Gentle Dentistry

  • Health Maintenance Organization
  • Powhatan, VA
  • NPI 1699912816
  NPD (past)

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

{
    "created_epoch": "1434499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572220800000",
    "number": "1902287683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2105 ACADEMY RD STE J",
            "city": "POWHATAN",
            "state": "VA",
            "postal_code": "231395829",
            "telephone_number": "804-598-8951",
            "fax_number": "804-598-7527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 N 4TH AVE",
            "city": "HOPEWELL",
            "state": "VA",
            "postal_code": "238602504",
            "telephone_number": "804-458-3004",
            "fax_number": "804-458-3056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPPARD",
        "first_name": "JACOB",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-17",
        "last_updated": "2019-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401414898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Second Chances Comprehensive Services
• Serene Serenity Psychiatry
• Jennifer Shaffer
• Rakesh Kumar Shah, MD
• Shamin-Hopewell Assisted Living
• Jaimoon Marcus Shim, M.D.
• Siblingcare Enterprise
• Salman Siddiqui, M.D.
• Mark A Simonetta, LCSW
• Sandra Simons, M.D.

• General Practice Dentistry in Hopewell, VA
• Providers in Hopewell, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2019; 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.