SCOTT JACKS, DDS, INC (NPI# 1609041482) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609041482 |
| Entity Type | Organization |
| Organization Name | SCOTT JACKS, DDS, INC |
| Other Organization Name | CHILDREN'S DENTAL GROUP |
| Practice Address |
1153 S King Rd San Jose CA 95122-2144 |
| Mailing Address |
4444 Tweedy Blvd South Gate CA 90280-6304 |
| Practice Telephone | 3235642444 |
| Mailing Telephone | 3235642444 |
| Mailing Fax Number | 3232497565 |
| Enumeration Date | 2008-04-23 |
| 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 | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
31668 | CA | Dental Providers |
| N | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
31668 | CA | Dental Providers |
| Y | 122300000X | Dentist | 31668 | CA | Dental Providers |
| Other Name | Type Code |
|---|---|
| CHILDREN'S DENTAL GROUP | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336542851 | Scott Jacks, Dds, Inc | Dentist | 4138 Maine Ave Ste M2, Baldwin Park, CA 91706-3302 | 2014-09-29 |
| 1780982074 | Scott Jacks, Dds, Inc | Dentist | 897 E El Camino Real, Sunnyvale, CA 94087-2937 | 2011-03-10 |
| 1194928614 | Scott Jacks, Dds, Inc | Dentist | 4354 Tweedy Blvd, South Gate, CA 90280-6237 | 2007-06-11 |
| 1043414576 | Scott Jacks, Dds, Inc | Dentist | 20700 Avalon Blvd, Suite 600, Carson, CA 90746-3701 | 2007-06-11 |
| 1497961858 | Scott Jacks, Dds, Inc | Dentist | 2700 Colorado Blvd Ste 263, Los Angeles, CA 90041-1048 | 2007-05-15 |
| 1871632745 | Scott Jacks, Dds, Inc | Dentist | 2144 S Bristol St, Santa Ana, CA 92704-5123 | 2007-02-06 |
| 1588703458 | Scott Jacks, Dds, Inc | Dentist | 2156 E Lincoln Ave, Anaheim, CA 92806-4104 | 2007-02-06 |
| Street Address |
1153 S KING RD |
| City | SAN JOSE |
| State | CA |
| Zip Code | 95122-2144 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437788015 | Vietnam Pharmacy Inc | Pharmacy | 2451 S King Rd Suite A1, San Jose, CA 95122 | 2020-04-06 |
| 1346894524 | Amy Le Tran | Counselor | Mekong Community Center, 2203 Tully Road, San Jose, CA 95122 | 2019-07-26 |
| 1164980439 | Tri Starr Home Care, LLC | PACE Provider Organization | 1609 Flanigan Dr., Unit H, Unit H, San Jose, CA 95122 | 2019-03-06 |
| 1740761196 | Aileen Phu | Acupuncturist | 1271 Story Rd Ste 50, San Jose, CA 95122 | 2018-08-23 |
| 1740775816 | Urgent Care Clinic of Northern Ca Inc | Clinic/Center | 999 Story Road, Suite 9021, San Jose, CA 95122 | 2018-06-29 |
| 1952825911 | Robert Martin Thomas | Counselor | 950 Julian St, San Jose, CA 95122 | 2017-08-01 |
| 1497113153 | Jamealle Spain | Case Manager/Care Coordinator | 2070 Lucretia Ave #310, San Jose, CA 95122 | 2016-02-09 |
| 1770915035 | Thinh Tran | Dentist | 919 Story Rd Unit 1128, San Jose, CA 95122 | 2013-08-08 |
| 1356591333 | Asian American Recovery Services | Counselor | 1340 Tully Rd., San Jose, CA 95122 | 2008-09-25 |
| 1821246505 | Samara Rachel Stone | Marriage & Family Therapist | 1340 Tully Road, Suite 304, San Jose, CA 95122 | 2008-09-05 |
| Find all providers in zip 95122 | ||||
| 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 |
|---|---|---|---|---|
| 1558961359 | Tony Tataro | Dentist | 5700 Village Oaks Dr Apt 1222, San Jose, CA 95123-3771 | 2020-10-29 |
| 1306445689 | Vu Anh Tran | Dentist | 45 Via De Guadalupe, San Jose, CA 95116-2561 | 2020-10-19 |
| 1538775028 | Meera Sravan Kumar | Dentist | 451 Blossom Hill Rd Ste 20, San Jose, CA 95123-1658 | 2020-09-20 |
| 1750993937 | Ana Gloria Saint-hilaire | Dentist | 4676 Mia Cir, San Jose, CA 95136-2341 | 2020-08-19 |
| 1134746779 | Woodlief Dentistry & Associates, PC | Dentist | 750 N Capitol Ave Ste A2, San Jose, CA 95133-1902 | 2020-06-30 |
| 1871120485 | Brittany Chou | Dentist | 136 Birch Ln, San Jose, CA 95127-2310 | 2020-03-24 |
| 1164054235 | Amritha Raghunath Minisandram | Dentist | 7058 Heartland Way, San Jose, CA 95135-2234 | 2020-02-06 |
| 1124582580 | Mahsa Esfandiari | Dentist | 1706 Morocco Dr, San Jose, CA 95125-5823 | 2019-01-29 |
| 1689138547 | Quan Phuong Huynh | Dentist | 1855 Alum Rock Ave Ste B, San Jose, CA 95116-1398 | 2019-01-24 |
| 1790257848 | Sandra P. Lara Dds . Inc | Dentist | 1360 N Winchester Blvd Ste 3, San Jose, CA 95128-1150 | 2018-12-28 |
| Find all providers in SAN JOSE | ||||
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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.