MEDICARE: JACOB KAMM DMD

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	122300000X	Dentist	30.027550	OH

General Provider Information

NPI Number	:	1912751165
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACOB KAMM DMD

Provider Business Mailing Address
First Line	:	6165 SOM CENTER RD
Second Line	:
City	:	SOLON
State	:	OH
Zip	:	44139-2974
Country	:	US
Telephone Number	:	440-498-8200
Fax Number	:

Provider Business Practice Location Address
First Line	:	6165 SOM CENTER RD
Second Line	:
City	:	SOLON
State	:	OH
Zip	:	44139-2974
Country	:	US
Telephone Number	:	440-498-8200
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/15/2024
Last Update Date	:	12/23/2025

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