Jacob Groom, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE61203036 Issued in WA

Practice address

7012 NE 40TH St
Vancouver, WA 98661-3052

Phone

(360) 254-5254

NPI assigned

Jun 25, 2021

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Jacob D Groom DMD PLLC

  • General Practice Dentistry
  • Vancouver, WA
  • NPI 1699560300
  NPD Authorized official
• J Winger, DDS, PLLC

  • General Practice Dentistry
  • Vancouver, WA
  • NPI 1134093065
  NPD
• Wendel Family Dental Centre PS

  • General Practice Dentistry
  • Vancouver, WA
  • NPI 1295844900
  NPD (past)

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

{
    "created_epoch": "1624579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744329600000",
    "number": "1902476682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4530 NW WALDEN ST",
            "city": "CAMAS",
            "state": "WA",
            "postal_code": "986079130",
            "telephone_number": "503-702-6532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7012 NE 40TH ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986613052",
            "telephone_number": "360-254-5254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROOM",
        "first_name": "JACOB",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-25",
        "last_updated": "2025-04-11",
        "certification_date": "2025-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE61203036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grin and Bear It Dental Clinic
• Tracy Lynn Grindle, EFDA
• Griswold Home Care Registry
• Mariya Grizhinku
• Bobbie Berna Groom, RN
• Jennessa Offutt Groom, FNP
• Christina G Grooms
• Darren Lamar Grooms
• Scott Edward Gross, DC, MS
• Anne E Grossman, MD

• General Practice Dentistry in Vancouver, WA
• Providers in Vancouver, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2025; 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.