MEDICARE: JONATHAN JACOBY DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	2015016758	MO

General Provider Information

NPI Number	:	1023490893
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JONATHAN JACOBY DDS

Provider Business Mailing Address
First Line	:	1411 S RANGE LINE RD
Second Line	:
City	:	JOPLIN
State	:	MO
Zip	:	64801-5589
Country	:	US
Telephone Number	:	417-553-7377
Fax Number	:	417-553-7293

Provider Business Practice Location Address
First Line	:	1411 S RANGE LINE RD
Second Line	:
City	:	JOPLIN
State	:	MO
Zip	:	64801-5589
Country	:	US
Telephone Number	:	417-553-7377
Fax Number	:	417-553-7293

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/29/2015
Last Update Date	:	06/29/2015

Similar Medicare Providers

1922273481 — DR. SHANNON CAROL CLARK DDS
Practice Location Address:

1411 S RANGE LINE RD
JOPLIN, MO
64801-5589

Practice Phone: 417-541-2666
Practice Fax:

1306266267 — EMILY KATHERINE HANDLEY, DDS, PC
Practice Location Address:

1411 S RANGE LINE RD
JOPLIN, MO
64801-5589

Practice Phone: 417-553-7377
Practice Fax:

1902800659 — DR. THOMAS K HAMILTON D.O.
Practice Location Address:

1027 S MAIN ST LOWR 3
JOPLIN, MO
64801-4521

Practice Phone: 417-781-6722
Practice Fax: 417-781-2090

1659379568 — LEWIS OPTICAL, INC
Practice Location Address:

825 S MAIDEN LN
JOPLIN, MO
64801-3803

Practice Phone: 417-781-6644
Practice Fax:

1598764110 — COLLEGE SKYLINE CENTER LLC
Practice Location Address:

1230 N DUQUESNE RD
JOPLIN, MO
64801-1509

Practice Phone: 417-782-1443
Practice Fax: 417-782-3240

1770582280 — DR. ROGER DALE PAIGE PH.D.
Practice Location Address:

1230 N DUQUESNE RD
JOPLIN, MO
64801-1509

Practice Phone: 417-782-1443
Practice Fax: 417-782-3240

Directions to “ JONATHAN JACOBY DDS” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.