ROBERT B JACOB, DDS, INC (NPI# 1992175699) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992175699 |
| Entity Type | Organization |
| Organization Name | ROBERT B JACOB, DDS, INC |
| Practice Address |
4617 Ruffner St Ste 200 San Diego CA 92111-2284 |
| Practice Telephone | 8582681006 |
| Practice Fax Number | 8582685097 |
| Mailing Telephone | 8582681006 |
| Mailing Fax Number | 8582685097 |
| Enumeration Date | 2015-10-07 |
| Last Update Date | 2015-10-07 |
| Authorized Official Name | ROBERT B JACOB (PRESIDENT) |
| Authorized Official Telephone | 8582681006 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
B25912 | CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | B25912-01 | 05 |
| Street Address |
4617 RUFFNER ST STE 200 |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92111-2284 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215093315 | Robert B Jacob | Dentist | 4617 Ruffner St Ste 200, San Diego, CA 92111-2284 | 2006-12-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982220653 | Karen Elizabeth Mitchell | Registered Nurse | County of San Diego California Children's Services (ccs, 6991 Balboa Ave, (room 70), San Diego, CA 92111 | 2020-06-18 |
| 1912523804 | Access Medical, Inc. | Durable Medical Equipment & Medical Supplies | 4150 Convoy Street, Suite A, San Diego, CA 92111 | 2020-06-17 |
| 1154944551 | Mei Ling Milan Szeto | Student in an Organized Health Care Education/Training Program | 7917 Ostrow Street, Suite A, San Diego, CA 92111 | 2020-05-20 |
| 1346893831 | Leticia Isabel Peralta | Assistant Behavior Analyst | 563 Balboa Avenue. Number 521, San Diego, CA 92111 | 2019-07-23 |
| 1295204394 | Demetria Serfas | Behavioral Analyst | 563 Balboa Ave #521, San Diego, CA 92111 | 2018-11-19 |
| 1568981678 | Ross Psychology | Psychologist | 4883 Ronson Court, Suite K, San Diego, CA 92111 | 2017-09-11 |
| 1225554587 | Bianca Acosta | Technician, Other | 563 Balboa Ave. #521, San Diego, CA 92111 | 2017-08-18 |
| 1194240085 | Kazuhiro Kato | Dentist | 3707 Convoy St., San Diego, CA 92111 | 2017-08-11 |
| 1073038527 | Joanne Epps-yentz | Licensed Vocational Nurse | 7414 Mesa College Dr. Apt 47, San Diego, CA 92111 | 2017-08-06 |
| 1184158446 | Positive Behavior Supports Corp | Community/Behavioral Health | 563 Balboa Ave, 521, San Diego, CA 92111 | 2017-04-13 |
| Find all providers in zip 92111 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437776812 | Andy L. Tieu Dds Inc. | Clinic/Center | 10549 Scripps Poway Pkwy Ste I, San Diego, CA 92131-3963 | 2020-07-01 |
| 1851925481 | Santos Salsbury Dental Corporation | Clinic/Center | 6699 Alvarado Rd Ste 2202, San Diego, CA 92120-5293 | 2020-02-22 |
| 1194365015 | Valadez Dental Corp | Clinic/Center | 2650 Camino Del Rio N Ste 102, San Diego, CA 92108-1630 | 2020-01-08 |
| 1619434065 | Marco Savittieri, Dds., Inc. | Clinic/Center | 12613 El Camino Real Unit A, San Diego, CA 92130-4077 | 2019-02-21 |
| 1760977516 | Jeremy Walker Dental Corporation | Clinic/Center | 3330 3rd Ave Ste 302, San Diego, CA 92103-5639 | 2018-06-25 |
| 1235629502 | Ricardo Peralta Dds Inc | Clinic/Center | 9855 Erma Rd Ste 103, San Diego, CA 92131-1007 | 2018-05-12 |
| 1326535576 | Ryan Wallrich Dmd, PC | Clinic/Center | 1310 Rosecrans St Ste B, San Diego, CA 92106-4609 | 2018-04-13 |
| 1356847438 | Arvinda Reddy Kunduru, Dds Inc. | Clinic/Center | 5440 Morehouse Dr Ste 1800, San Diego, CA 92121-6705 | 2018-04-05 |
| 1447767447 | Florabel F. Oliver-badillo Dmd, Inc. | Clinic/Center | 10717 Camino Ruiz Ste 122, San Diego, CA 92126-2362 | 2017-12-29 |
| 1073036539 | Balboa Family Dentistry | Clinic/Center | 3737 Moraga Ave Ste B307, San Diego, CA 92117-5360 | 2017-07-17 |
| Find all providers in SAN DIEGO | ||||
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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.