Individual
DR. JACOB JOHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
054091
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
054091
NEW YORK STATE DENTAL LICENSE
NY
Enumeration date
08/12/2008
Last updated
03/27/2026
Update your record
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