DR. GREGG ANDREW JACOB (NPI# 1164540233) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164540233 |
| Entity Type | Individual |
| Full Name | DR. GREGG ANDREW JACOB |
| Credential | D.M.D. |
| Practice Address |
83 Hanover Rd Ste 240 Florham Park NJ 07932-1508 |
| Practice Telephone | 9733601100 |
| Practice Fax Number | 9733601101 |
| Mailing Telephone | 9733601100 |
| Mailing Fax Number | 9733601101 |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
22DI02252800 | NJ | Dental Providers |
| N | 204E00000X | Oral & Maxillofacial Surgery | 054217-1 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | 91001810700 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2001 Marcus Ave, Ste N-10, New Hyde Park, NY 110421011 | 5167751818 | 5167750892 |
| Street Address |
83 HANOVER RD STE 240 |
| City | FLORHAM PARK |
| State | NJ |
| Zip Code | 07932-1508 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831618529 | Northeast Facial and Oral Surgery Specialists, LLC | Dentist | 83 Hanover Rd Ste 240, Florham Park, NJ 07932-1508 | 2017-09-13 |
| 1497190722 | Jessica S Lee | Oral & Maxillofacial Surgery | 83 Hanover Rd Ste 240, Florham Park, NJ 07932-1508 | 2013-04-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700487162 | Tender Care | Community/Behavioral Health | 2 Independence Way, Apt. 102, Florham Park, NJ 07932 | 2020-11-03 |
| 1780174524 | Ghada Cieri | Registered Nurse | 30 B Vreeland Road, Suite 200, Florham Park, NJ 07932 | 2018-05-17 |
| 1386192706 | Bai Li Medical Health Center | Point of Service | 171 Ridgedale Ave., Ste. 1f, Florham Park, NJ 07932 | 2016-09-14 |
| 1942756580 | Elizabeth Savino | Social Worker | 10 Hanover Road, Florham Park, NJ 07932 | 2016-09-01 |
| 1790182426 | John A Carollo Dmd Pa | Clinic/Center | 131 Columbia Turnpike, Suite 2a, Florham Park, NJ 07932 | 2014-11-24 |
| 1306265673 | Rachel Myra Fitz | Anesthesiology | 30b Vreeland Rd Ste 200, Florham Park, NJ 07932 | 2014-04-15 |
| 1922442615 | Allison Ann Sopko | Pediatrics | 195 Columbia Tpke Ste 105, Florham Park, NJ 07932 | 2013-04-24 |
| 1770869315 | Nexpc1 LLC | Internal Medicine | 128 Columbia Turnpike, Suite 101, Florham Park, NJ 07932 | 2011-10-27 |
| 1528356391 | Daniel Timothy Streeter | Physical Therapist | 30 Vreeland Rd., Building A Suite #110, Florham Park, NJ 07932 | 2011-07-14 |
| 1558672964 | Anna Marie Seavey | Dietitian, Registered | 83 Hanover Road, Suite 190, Florham Park, NJ 07932 | 2010-06-30 |
| Find all providers in zip 07932 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831618529 | Northeast Facial and Oral Surgery Specialists, LLC | Dentist | 83 Hanover Rd Ste 240, Florham Park, NJ 07932-1508 | 2017-09-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124638861 | Riverside Oral Surgery - Edison | Dentist | 80 Route 27, Edison, NJ 08820-3985 | 2020-08-07 |
| 1881227056 | New Jersey Oral Surgery & Dental Implants LLC | Dentist | 87 Route 520, Morganville, NJ 07751-1241 | 2020-02-17 |
| 1003457441 | Madison Dentistry LLC | Dentist | 268 Main Street, Suite B, Madison, NJ 07940 | 2019-10-07 |
| 1508424284 | Posh Dental LLC | Dentist | 39 Tallman Pl Ste 2, Englewood, NJ 07631-2702 | 2019-05-29 |
| 1124598230 | Jc Oral Health Care Pa | Dentist | 103 Greene St Fl 2, Jersey City, NJ 07302-3868 | 2018-12-01 |
| 1801370366 | Palisades Park Dental P.C. | Dentist | 225 Broad Ave # 102, Palisades Park, NJ 07650-1588 | 2018-09-20 |
| 1881174969 | Bethel Oral Surgery & Implants, PC | Dentist | 1319 Anderson Ave Ste D, Fort Lee, NJ 07024-1734 | 2018-08-17 |
| 1790271641 | Morristown Oral Surgery & Implantology Associates LLC | Dentist | 290 Madison Ave Ste 1, Morristown, NJ 07960-7401 | 2018-07-03 |
| 1255826939 | Riverside Oral Surgery - Livingston | Dentist | 209 S Livingston Ave Ste 2, Livingston, NJ 07039-4042 | 2018-06-26 |
| 1295249456 | Pa Dental LLC | Dentist | 17 Main St Ste 301, Robbinsville, NJ 08691-1401 | 2017-11-27 |
| Find all providers with the same taxonomy | ||||
| City | FLORHAM PARK |
| Zip Code | 07932 |
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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.