Jerome Tabacca, D.D.S.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

OH14335 Issued in OH

Practice address

1707 Bethel Rd
Columbus, OH 43220-1810

Phone

(614) 459-0050

Fax

(614) 459-1955

NPI assigned

Jun 1, 2005

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

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

State licenses

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

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1942202163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1707 BETHEL RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432201810",
            "telephone_number": "614-459-0050",
            "fax_number": "614-459-1955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1707 BETHEL RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432201810",
            "telephone_number": "614-459-0050",
            "fax_number": "614-459-1955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TABACCA",
        "first_name": "JEROME",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-01",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "OH",
            "license": "OH14335",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "432538",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• T Top Movers (T Top 19)
• T&S Youth Project
• T&T Medical Transportation
• Katherine Gia Ta-McIntyre, APRN-CNP
• Hoang M Ta, DO
• Sean A Tabaie, M.D.
• Tarek Tabbaa, M.D.
• Sammy Mouhamad Tabbah, MD
• Linda Tabe, LPN
• Jennifer Taber

• Periodontics in Columbus, OH
• Providers in Columbus, OH by specialty
• Periodontics in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.