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General NPI Number Information
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NPI Number | 1487055661
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Entity Type | Individual
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Provider Name | CHAIM ALEN JAKOB DMD
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Gender | Male
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Dates
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Enumeration Date | 09/08/2014
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Last Update Date | 11/07/2024
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Provider Practice Location Address
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Address Line | 7301 W PALMETTO PARK RD STE 205C
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City | BOCA RATON
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State | FL
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Zip | 33433-3456
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Country | US
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Telephone | 561-990-3636
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Fax |
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Provider Business Mailing Address
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Address Line | 7301 W PALMETTO PARK RD STE 205C
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City | BOCA RATON
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State | FL
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Zip | 33433-3456
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Country | US
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Telephone | 516-990-3636
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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 | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 057602
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | DN26566
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License Number State | FL
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