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General NPI Number Information
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NPI Number | 1225359003
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Entity Type | Individual
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Provider Name | LORRAINE VINITHA JACOB D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 06/16/2010
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Last Update Date | 10/29/2025
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Provider Practice Location Address
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Address Line | 25900 CINCO RANCH BLVD
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City | KATY
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State | TX
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Zip | 77494-2988
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Country | US
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Telephone | 281-347-1993
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Fax |
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Provider Business Mailing Address
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Address Line | 14746 CINDYWOOD DR
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City | HOUSTON
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State | TX
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Zip | 77079-6410
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 0025598
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License Number State | TX
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