Provider Demographics
NPI:1598641334
Name:JACOBS, JESSICA JORDAN (DMD)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:JORDAN
Last Name:JACOBS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 SPECKLE ST APT 57
Mailing Address - Street 2:
Mailing Address - City:MILLS RIVER
Mailing Address - State:NC
Mailing Address - Zip Code:28759-0151
Mailing Address - Country:US
Mailing Address - Phone:352-457-7626
Mailing Address - Fax:
Practice Address - Street 1:42 PARK PL E STE 101
Practice Address - Street 2:
Practice Address - City:BREVARD
Practice Address - State:NC
Practice Address - Zip Code:28712-4362
Practice Address - Country:US
Practice Address - Phone:828-830-1789
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-15
Last Update Date:2025-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC144321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice