DR. GHASSAN ELIAS JACKLIS D.M.D NPI 1659614410

NPI Information

NPI: 1659614410
Provider Name: DR. GHASSAN ELIAS JACKLIS, D.M.D
Classification: Dentist - 1223G0001X
Specialization: General Practice
Entity Type: Individual
PECOS Registration: Yes
Address: 11125 ROCKVILLE PIKE STE 204
ROCKVILLE, MD
ZIP 20852
Phone: (301) 888-6666

Map and Directions

Get Directions

NPI Details

DR. Ghassan Elias Jacklis, D.M.D is a general practice dentist in Rockville, MD. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. DR. Ghassan Elias Jacklis, D.M.D NPI is 1659614410. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

11125 ROCKVILLE PIKE STE 204
ROCKVILLE, MD
ZIP 20852-142
Phone: (301) 888-6666

The NPI 1659614410 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 3/30/2013 and was last updated on 5/7/2018.

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	1223G0001X	Dentist	General Practice	1001256	DISTRICT OF COLUMBIA	No
2	1223G0001X	Dentist	General Practice	11991	MARYLAND	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0401413871	OTHER	VIRGINIA	LICENSE
2	11991	OTHER	MARYLAND	LICENSE NUMBER

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: 11/21/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

Previous NPI

Next NPI