SCOTT JACKS DDS INC (NPI# 1366549545) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366549545 |
| Entity Type | Organization |
| Organization Name | SCOTT JACKS DDS INC |
| Other Organization Name | CHILDREN'S DENTAL GROUP |
| Practice Address |
4444 Tweedy Blvd South Gate CA 90280-6304 |
| Practice Telephone | 3235642444 |
| Practice Fax Number | 5642497565 |
| Mailing Telephone | 3235642444 |
| Mailing Fax Number | 5642497565 |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2015-09-23 |
| Authorized Official Name | DR. JERRY DAVID MINSKY (OWNER) |
| Authorized Official Telephone | 3235642444 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223E0200X |
Dentist Specialization: Endodontics |
31668 | CA | Dental Providers |
| N | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
31668 | CA | Dental Providers |
| N | 1223P0300X |
Dentist Specialization: Periodontics |
31668 | CA | Dental Providers |
| N | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
31668 | CA | Dental Providers |
| N | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
31668 | CA | Dental Providers |
| Y | 122300000X | Dentist | 31668 | AZ | Dental Providers |
| Other Name | Type Code |
|---|---|
| CHILDREN'S DENTAL GROUP | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790824662 | Scott Jacks Dds Inc | Dentist | 14119 Pioneer Blvd, Norwalk, CA 90650-3925 | 2007-02-06 |
| Street Address |
4444 TWEEDY BLVD |
| City | SOUTH GATE |
| State | CA |
| Zip Code | 90280-6304 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770101081 | Habib Adib | Dentist | 4444 Tweedy Blvd, South Gate, CA 90280-6304 | 2020-07-13 |
| 1760908230 | Western Dental Service, Inc | Dentist | 4444 Tweedy Blvd, South Gate, CA 90280-6304 | 2017-08-16 |
| 1306173158 | Rana Rushdi Kaleel | Dentist | 4444 Tweedy Blvd, South Gate, CA 90280-7076 | 2009-11-14 |
| 1538391263 | Benjamin Phillip Sapir | Dentist | 4444 Tweedy Blvd, South Gate, CA 90280-6304 | 2009-08-13 |
| 1770617003 | Daniel Teboul | Dentist | 4444 Tweedy Blvd, South Gate, CA 90280-6304 | 2007-03-16 |
| 1871630673 | Roy Miyamoto | Dentist | 4444 Tweedy Blvd, South Gate, CA 90280-6304 | 2007-01-31 |
| 1710024914 | Maria H Lima | Dentist | 4444 Tweedy Blvd, South Gate, CA 90280-6304 | 2007-01-30 |
| 1043356728 | Sabina Wiederkehr | Dentist | 4444 Tweedy Blvd, South Gate, CA 90280-6304 | 2007-01-29 |
| 1497891261 | Eleanor Antoinette Siazon | Dentist | 4444 Tweedy Blvd, South Gate, CA 90280-6304 | 2007-01-29 |
| 1194861872 | Irina Mihaela Tarnavsky | Dentist | 4444 Tweedy Blvd, South Gate, CA 90280-6304 | 2007-01-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861989758 | Downey Family Cosmetic Dentistry | Clinic/Center | 9212 Lakewood Blvd, Downey, CA 90280 | 2018-04-17 |
| 1720529936 | Carewest Non-emergency Services, LLC | Non-emergency Medical Transport (VAN) | 10423 Atlantic Ave, South Gate, CA 90280 | 2017-03-20 |
| 1669844593 | Consumerhealth, Inc. | Dentist | 9918 Atlantic Aveneue, South Gate, CA 90280 | 2015-10-30 |
| 1366810988 | T & T Care Inc | Pharmacy | 8330 Long Beach Blvd Ste 112, South Gate, CA 90280 | 2015-09-14 |
| 1831579234 | Mariana Silva | Licensed Psychiatric Technician | 8160 Victoria Ave. Apt. A, South Gate, CA 90280 | 2015-06-02 |
| 1417396060 | Compatior, Inc. | Community/Behavioral Health | 4363 Tweedy Blvd, South Gate, CA 90280 | 2013-06-17 |
| 1508158197 | Eddy Ang | Family Medicine | 8627 Atlantic Ave, South Gate, CA 90280 | 2011-05-13 |
| 1750528691 | Herbert Perez | Dental Assistant | 4149 Tweey Blvd #j, South Gate, CA 90280 | 2009-01-14 |
| 1962615773 | Harold Edward Potts | Chiropractor | 10010 California Ave., South Gate, CA 90280 | 2007-05-08 |
| 1821113507 | Magdy F Tadros | Dentist | 3173 Tweedy Blvd, South Gate, CA 90280 | 2007-03-20 |
| Find all providers in zip 90280 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255859823 | Western Dental Services, Inc. | Dentist | 4424 Tweedy Blvd, South Gate, CA 90280-6304 | 2017-09-05 |
| 1497287650 | Shaila Torbati and Dona Torbati Dds Inc | Dentist | 12124 Garfield Ave, South Gate, CA 90280-8033 | 2017-03-28 |
| 1154705069 | Sahawneh Dental Corporation | Dentist | 9918 Atlantic Ave, South Gate, CA 90280-6449 | 2015-07-10 |
| 1841538998 | Shaila Torbati Dds and Dona Torbati Dds Inc | Dentist | 8116 California Ave, Suite C, South Gate, CA 90280-2400 | 2013-01-24 |
| 1578866430 | Enriqueta Carmona | Dentist | 4096 Tweedy Blvd, South Gate, CA 90280-6147 | 2010-12-15 |
| 1871743781 | Noran Jeong | Dentist | 8928 State St, South Gate, CA 90280-2926 | 2008-09-27 |
| 1407037906 | Leticia J Jacobs | Dentist | 8200 Long Beach Blvd, #e, South Gate, CA 90280-2057 | 2007-11-26 |
| 1114125887 | Jose Luis Flores | Dentist | 8617 California Ave, South Gate, CA 90280-3003 | 2007-07-04 |
| 1548478399 | Larissa Gushansky | Dentist | 3175 Firestone Blvd # 200, South Gate, CA 90280-2951 | 2007-05-17 |
| 1467668012 | Edward S Liu | Dentist | 4149 Tweedy Blvd Ste J, South Gate, CA 90280-6167 | 2007-05-14 |
| Find all providers in SOUTH GATE | ||||
| City | SOUTH GATE |
| Zip Code | 90280 |
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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.