NPI Code Detail JSON Logo

1750741716 NPI number — CASEY JACOBSEN D.D.S.

NPI Number: 1750741716
Health Care Provider/Practitioner: CASEY JACOBSEN D.D.S.

Information about “1750741716” NPI (CASEY JACOBSEN D.D.S.) exists in 1750741716 in HTML format HTML  |  1750741716 in plain Text format TXT  |  1750741716 in PDF (Portable Document Format) PDF  |  1750741716 in an XML format XML  formats.

NPI Number : 1750741716 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1750741716",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "JACOBSEN",
    "FirstName": "CASEY",
    "MiddleName": null,
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "D.D.S.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "400 12TH AVE WEST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "COLUMBIA FALLS",
    "MailingAddressStateName": "MT",
    "MailingAddressPostalCode": "59912",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "406-892-2104",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "6360 US HIGHWAY 93 S",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "WHITEFISH",
    "PracticeLocationAddressStateName": "MT",
    "PracticeLocationAddressPostalCode": "59937-8235",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "406-862-7895",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "03/02/2016",
    "LastUpdateDate": "04/14/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "122300000X",
          "TaxonomyName": "Dentist",
          "LicenseNumber": "DR60651464",
          "LicenseNumberStateCode": "WA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "122300000X",
          "TaxonomyName": "Dentist",
          "LicenseNumber": "DE60732567",
          "LicenseNumberStateCode": "WA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "122300000X",
          "TaxonomyName": "Dentist",
          "LicenseNumber": "16442",
          "LicenseNumberStateCode": "MT",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.