MEDICARE: JACOBSON DENTAL CORP

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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry

General Provider Information

NPI Number	:	1568857464
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JACOBSON DENTAL CORP

Provider Business Mailing Address
First Line	:	3655 TORRANCE BLVD STE 425
Second Line	:
City	:	TORRANCE
State	:	CA
Zip	:	90503-4844
Country	:	US
Telephone Number	:	916-877-7450
Fax Number	:	844-534-8464

Provider Business Practice Location Address
First Line	:	4074 FAIRMOUNT AVENUE
Second Line	:	SUITE B
City	:	SAN DIEGO
State	:	CA
Zip	:	92105
Country	:	US
Telephone Number	:	691-996-9543
Fax Number	:	844-534-8464

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JEFFREY JACOBSON
Credential	:	DMD
Telephone Number	:	916-877-7450

Provider Enumeration Date	:	03/30/2015
Last Update Date	:	03/06/2024

Similar Medicare Providers

1417892175 — LALEH RAHMANI
Practice Location Address:

4060 FAIRMOUNT AVE
SAN DIEGO, CA
92105-1608

Practice Phone: 619-280-4213
Practice Fax:

1992640650 — MISS DENISE A STENT AMFT
Practice Location Address:

4356 MCCLINTOCK ST APT E
SAN DIEGO, CA
92105-1076

Practice Phone: 760-579-9188
Practice Fax:

1073458485 — MS. LINH TIEU TRAN
Practice Location Address:

5220 STREAMVIEW DR
SAN DIEGO, CA
92105-3204

Practice Phone: 619-467-9442
Practice Fax:

1538232335 — DR. TRUNG QUY TRAN MD
Practice Location Address:

4139 UNIVERSITY AVENUE
SAN DIEGO, CA
92105

Practice Phone: 619-281-3443
Practice Fax: 619-281-7193

1689340572 — DANLU LI
Practice Location Address:

5348 UNIVERSITY AVE
SAN DIEGO, CA
92105-8025

Practice Phone: 619-255-7550
Practice Fax:

1093023509 — MS. MICHELLE JACKSON NP
Practice Location Address:

5434 OLIVE ST UNIT A
SAN DIEGO, CA
92105-5054

Practice Phone: 619-840-9440
Practice Fax:

1255274668 — DIANA CAMILA AYALA
Practice Location Address:

3767 CENTRAL AVE
SAN DIEGO, CA
92105-2599

Practice Phone: 619-278-0777
Practice Fax:

Directions to “JACOBSON DENTAL CORP ” 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.