Healthcare Provider Details

I. General information

NPI: 1477046472
Provider Name (Legal Business Name): JACOB HARRISON URAM DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/13/2018
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

232 DOVE RUN CENTRE DR
MIDDLETOWN DE
19709-7971
US

IV. Provider business mailing address

232 DOVE RUN CENTRE DR
MIDDLETOWN DE
19709-7971
US

V. Phone/Fax

Practice location:
  • Phone: 302-449-6810
  • Fax: 302-449-6222
Mailing address:
  • Phone: 302-449-6810
  • Fax: 302-449-6222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberG1-0001457
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: