MRS. TRACEY LEIGH JACOB (NPI# 1124507421) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124507421 |
| Entity Type | Individual |
| Full Name | MRS. TRACEY LEIGH JACOB |
| Credential | RDH |
| Practice Address |
2850 Berkshire Dr Bloomfield Hills MI 48301-3400 |
| Practice Telephone | 5864899868 |
| Mailing Telephone | 5864899868 |
| Enumeration Date | 2018-08-08 |
| Last Update Date | 2018-08-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 124Q00000X | Dental Hygienist | 2902012495 | MI | Dental Providers |
| Street Address |
2850 BERKSHIRE DR |
| City | BLOOMFIELD HILLS |
| State | MI |
| Zip Code | 48301-3400 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386278992 | Next Level Home Care | Home Health | 3595 W Maple Rd Ste 208, Bloomfield Hills, MI 48301 | 2020-02-24 |
| 1811352230 | Freda B. Lerman, Lpc, Psyd, Lp, Pllc | Psychologist | 6905 Telegraph Road Suite 100, Bloomfield Hills, MI 48301 | 2015-12-30 |
| 1790113223 | Kathy Biehl Kelly | Nurse Practitioner | 3355 Morningview Terrace, Bloomfield Hills, MI 48301 | 2013-10-18 |
| 1538406855 | Dynamic Home Health Care Agency | Case Management | 3744 Lincoln Drive, Bloomfield Hills, MI 48301 | 2013-01-07 |
| 1366798373 | A3 Medical | Family Medicine | 4050 Maple Road, Suite 101, Bloomfield Township, MI 48301 | 2012-07-27 |
| 1013299361 | Michael Kovel Samson | Internal Medicine | 4790 Apple Grove Court, Bloomfield Hills, MI 48301 | 2011-09-13 |
| 1376786152 | Pamela Ann Hibbard Timrek | Speech-Language Pathologist | 3816 Lincoln Drive, Bloomfield Township, MI 48301 | 2009-04-09 |
| 1164694584 | Alexandra Krot | Internal Medicine | 169 Bassett Place, Bloomfield Hills, MI 48301 | 2008-03-26 |
| 1619170644 | Latha T Kannan, Md, PC | Internal Medicine | 6715 Birmingham Club Drive, Bloomfield Hills, MI 48301 | 2007-06-07 |
| 1699802975 | Rebeca Urquiola | Dentist | 4220 Surrey Cross, Bloomfield Hills, MI 48301 | 2007-02-27 |
| Find all providers in zip 48301 | ||||
| Taxonomy Code | 124Q00000X |
| Grouping | Dental Providers |
| Classification | Dental Hygienist |
| An individual who has completed an accredited dental hygiene education program, and an individual who has been licensed by a state board of dental examiners to provide preventive care services under the supervision of a dentist. Functions that may be legally delegated to the dental hygienist vary based on the needs of the dentist, the educational preparation of the dental hygienist and state dental practice acts and regulations, but always include, at a minimum, scaling and polishing the teeth. To avoid misleading the public, no occupational title other than dental hygienist should be used to describe this dental auxiliary. |
| Notes: Source: Comprehensive Policy Statement on Dental Auxiliaries, American Dental Association. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255853669 | Beverly Ann Gross | Dental Hygienist | 1384 Indian Mound E, Bloomfield Hills, MI 48301-2254 | 2017-07-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366042830 | Denisha Henry | Dental Hygienist | 28009 Berkshire Dr, Southfield, MI 48076-2449 | 2020-10-26 |
| 1477173367 | Susan B Leclair | Dental Hygienist | 6824 Brightwood Ct, Waterford, MI 48327-1100 | 2020-04-20 |
| 1053944686 | Elaine Christina Check | Dental Hygienist | 3510 Roosevelt Rd, Jackson, MI 49203-5263 | 2020-02-21 |
| 1720619257 | Angela Marie Compton | Dental Hygienist | 2668 Applewine, Middleville, MI 49333-8052 | 2020-02-03 |
| 1336789205 | Alaa Samir Solagh | Dental Hygienist | 7311 Appoline St, Dearborn, MI 48126-1570 | 2020-01-08 |
| 1952941825 | Ericka Melissa Smith | Dental Hygienist | 14577 Rosemont Ave, Detroit, MI 48223-2338 | 2020-01-08 |
| 1083254957 | Zahraa Solagh | Dental Hygienist | 6268 Whitefield St, Dearborn Heights, MI 48127-3013 | 2020-01-08 |
| 1811536261 | Melissa Ann Mccurtis | Dental Hygienist | 20700 Lockwood St, Taylor, MI 48180-2977 | 2020-01-02 |
| 1609415595 | Amanda Kilpatrick | Dental Hygienist | 11714 Belle River Rd, Riley, MI 48041-4322 | 2019-12-25 |
| 1366089732 | Vian Aljony | Dental Hygienist | 27273 Arden Park Cir, Farmington Hills, MI 48334 | 2019-12-04 |
| Find all providers with the same taxonomy | ||||
| City | BLOOMFIELD HILLS |
| Zip Code | 48301 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.