MACK JACOB, DDS (NPI# 1730615329) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730615329 |
| Entity Type | Organization |
| Organization Name | MACK JACOB, DDS |
| Practice Address |
2012 Prince St Berkeley CA 94703-2519 |
| Practice Telephone | 5108438568 |
| Practice Fax Number | 5108434448 |
| Mailing Telephone | 5108438568 |
| Mailing Fax Number | 5108434448 |
| Enumeration Date | 2017-05-03 |
| Last Update Date | 2017-05-03 |
| Authorized Official Name | MARILYN RODRIQUEZ (MANAGER) |
| Authorized Official Telephone | 5108438568 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | Dental Providers |
| Street Address |
2012 PRINCE ST |
| City | BERKELEY |
| State | CA |
| Zip Code | 94703-2519 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194845784 | Mack Jacob | Dentist | 2012 Prince St, Berkeley, CA 94703-2519 | 2007-03-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811553621 | Brittney Jerrilena Monique Garrett | Behavioral Analyst | 1901 Stuart St, Berkeley, CA 94703 | 2019-05-16 |
| 1740762178 | Maryam Jabbari Amiri | Student in an Organized Health Care Education/Training Program | 3075 Adeline Street, Suite 120, Berkeley, CA 94703 | 2018-09-01 |
| 1619427549 | Sigal Gafni | Occupational Therapist | 1622 Parker St. Apt. 1, Berkeley, CA 94703 | 2016-10-04 |
| 1750741138 | Ane Becker | Community Health Worker | 2026 Woolsey St, Berkeley, CA 94703 | 2016-02-29 |
| 1245697135 | Sara Dinome Teel Vargas | Chiropractor | 3286 Adeline St., Suite 9, Berkeley, CA 94703 | 2016-01-22 |
| 1083081608 | Olivia Debree | Nurse Practitioner | 3075 Adeline Street, Suite 280, Lifelong Medical Care, Ashby Health Center, Berkeley, CA 94703 | 2015-08-31 |
| 1962885988 | Caro Grosvenor | Marriage & Family Therapist | 1511 Ada Street, Berkeley, CA 94703 | 2015-07-08 |
| 1619378452 | Myles Malone | Counselor | 2413 Jefferson Ave., Berkeley, CA 94703 | 2014-09-11 |
| 1013340223 | Denise Daniel | Acupuncturist | 6222 La Salle Ave Suite B, Oakland, CA 94703 | 2013-08-12 |
| 1104126200 | Iramis Kouromenos | Dental Hygienist | 1721 University Ave Apt#209, Berkeley, CA 94703 | 2010-10-25 |
| Find all providers in zip 94703 | ||||
| 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 |
|---|---|---|---|---|
| 1568027183 | Leila Pakravan | Dentist | 2136 University Ave, Berkeley, CA 94704-1026 | 2019-05-08 |
| 1467921288 | Ethan Do | Dentist | 3017 Telegraph Ave Ste 310, Berkeley, CA 94705-2049 | 2018-11-21 |
| 1497112338 | Theodore Robert Small | Dentist | 1301 Bonita Ave Apt 4, Berkeley, CA 94709-1983 | 2016-01-22 |
| 1962817882 | Ian Iwane Dds | Dentist | 1536 Blake St, None, Berkeley, CA 94703-1806 | 2014-06-30 |
| 1932549235 | Erwin Yeh | Dentist | 1502 Walnut St Ste D, Berkeley, CA 94709-1563 | 2013-07-01 |
| 1144663766 | Alicia Applin | Dentist | 2812 Piedmont Ave, Berkeley, CA 94705-2314 | 2013-04-12 |
| 1588969919 | Martin L Goldman | Dentist | 900 Colusa Ave Ste 205-a, Berkeley, CA 94707-2319 | 2011-01-15 |
| 1316256712 | Anthony Murray Dailley | Dentist | 2999 Regent St Ste 302, Berkeley, CA 94705-2118 | 2010-10-02 |
| 1912239567 | Lindsey Koida | Dentist | 909 University Ave., Berkeley, CA 94710 | 2010-02-08 |
| 1568690824 | Brian Marc Assael | Dentist | 2459a Ashby Ave, Berkeley, CA 94705 | 2009-06-25 |
| Find all providers in BERKELEY | ||||
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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.