LISA SUSAN JACOB D.D.S. NPI 1386688331

NPI Information

NPI: 1386688331
Provider Name: LISA SUSAN JACOB, D.D.S.
Classification: Dentist - 1223P0221X
Entity Type: Individual

Specialization: Pediatric Dentistry

PECOS Registration: Yes

Address:
1301 BARBARA JORDAN BLVD
SUITE 307
AUSTIN, TX
ZIP 78723
Phone: (512) 324-9999
Get Directions

Lisa Susan Jacob, D.D.S. is a pediatric dentistry dentist in Austin, TX. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. Lisa Susan Jacob, D.D.S. NPI is 1386688331. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1301 BARBARA JORDAN BLVD
SUITE 307
AUSTIN, TX
ZIP 78723-077
Phone: (512) 324-9999
Fax: (512) 324-0645

The NPI 1386688331 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 6/16/2006 and was last updated on 12/11/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	122300000X	Dentist		19077	TEXAS	No
2	1223S0112X	Dentist	Oral and Maxillofacial Surgery	19077	TEXAS	No
3	1223P0221X	Dentist	Pediatric Dentistry	19077	TEXAS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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