Jakob Chris Bock, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9039 Issued in WA

Practice address

1950 Pottery Ave
Suite 4
Port Orchard, WA 98366-2592

Phone

(360) 876-6211

Fax

(360) 876-7952

NPI assigned

Nov 30, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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 2

Medicare fee-for-service enrollment

Enrolled in WA

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": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982771168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 POTTERY AVE",
            "address_2": "SUITE 4",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983662592",
            "telephone_number": "360-876-6211",
            "fax_number": "360-876-7952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 POTTERY AVE",
            "address_2": "SUITE 4",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983662592",
            "telephone_number": "360-876-6211",
            "fax_number": "360-876-7952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOCK",
        "first_name": "JAKOB",
        "middle_name": "CHRIS",
        "name_prefix": "Mr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "9039",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L & I PROVIDER #",
            "identifier": "0212605",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA PROV #",
            "identifier": "1516156",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Summerlee D Blankenship
• Trina Block, LMP
• Katherine RM Bloise, MD
• Melany K Bloomquist, DDS
• Bock and Hutchinson, PLLC
• Bodiwerks 1, Inc
• Tabitha Mae Bohren, RN BSN
• Regina B Bonnevie-Rogers, MD
• Terra Lynn Boulse, MA, CCC-SLP
• James William Boyett III, M.A.

• General Practice Dentistry in Port Orchard, WA
• Providers in Port Orchard, 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 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.