Robert B Jacob, DDS, Inc

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

B25912 Issued in CA

Legal business name

ROBERT B JACOB, DDS, INC

Practice address

4617 Ruffner St Ste 200
San Diego, CA 92111-2284

Phone

(858) 268-1006

Fax

(858) 268-5097

NPI assigned

Oct 7, 2015

Organization subpart

No

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

Authorized official

Name

Robert B Jacob, DDSNPI 1215093315

Title

President

Phone

(858) 268-1006

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Robert B Jacob, D.D.S.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • San Diego, CA
  • NPI 1215093315
  NPD (past) Authorized official

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

{
    "created_epoch": "1444176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444176000000",
    "number": "1992175699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4617 RUFFNER ST STE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921112284",
            "telephone_number": "858-268-1006",
            "fax_number": "858-268-5097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4617 RUFFNER ST STE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921112284",
            "telephone_number": "858-268-1006",
            "fax_number": "858-268-5097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT B JACOB, DDS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-07",
        "last_updated": "2015-10-07",
        "status": "A",
        "authorized_official_last_name": "JACOB",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "858-268-1006",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "CA",
            "license": "B25912",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "B25912-01",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Floyd E Roberson, M.D.
• Latoya Michaele Roberson, FNP-BC
• Tessa Roberson
• Robert a McPherson Professional Chiropractic
• Robert a. Meyerson, DDS, Inc.
• Robert Camhi DDS a Dental Corporation
• Robert D. Tonks, M.D., Inc
• Robert E Kearney MD Inc
• Robert E. Berry, DO PA
• Robert E. Berry, DO PA

• Dental Clinic/Center in San Diego, CA
• Providers in San Diego, CA by specialty
• Dental Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 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.