Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1982063228 Individual Practitioner Male Practitioner

Dr. Jacob Johnson , DMD

Dentist - General Practice • Sanford, FL

Professional Overview & Biography Verified Profile Summary

Dr. Jacob Johnson, DMD is a registered healthcare professional specializing in Dentist - General Practice in Sanford, FL. Practice services are available at 4930 E LAKE MARY BLVD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

4930 E Lake Mary Blvd

Sanford, FL 327715003

Telephone 4073228645
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Sanford, FL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 15.0 Yrs
Regional Practice Density
22 Specialists

Practicing in Sanford, FL (7473 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2021-06-21
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License FL HAD110

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Student in an Organized Health Care Education/Training Program

NUCC Taxonomy Code: 390200000X

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Secondary Practice Locations

5850 E Still Cir

Mesa, AZ 852063618

Phone: 4802196000

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Janine Kyte , ARNP

Nurse Practitioner - Family

NPI 1003050295

Advanced Registered Nurse Practitioner

Tochica Baptiste

Physician Assistant

NPI 1013880301
Jill Kornegay , ARNP

Nurse Practitioner - Pediatrics

NPI 1023012846

Advanced Registered Nurse Practitioner

NPI 1023061579

Doctor of Medicine (M.D.)

NPI 1033314398

Doctor of Medicine (M.D.)

Jessica Clemente , LCSW

Social Worker - Clinical

NPI 1033432745

Licensed Clinical Social Worker

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events
📍
Updated Practice Location June 21, 2021

Registered at 4930 E LAKE MARY BLVD, SANFORD, FL 327715003 (Tel: 4073228645)

📍
Updated Business Mailing Address June 21, 2021

Registered at 4930 E LAKE MARY BLVD, SANFORD, FL 327715003 (Tel: 4073228645)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 21, 2021

Dentist (License #HAD110 in FL)

NPI Profile Active February 15, 2016

NPI status registered as active in NPPES database

📍
Updated Practice Location February 15, 2016

Registered at 5850 E STILL CIR, MESA, AZ 852063618 (Tel: 4802196000)

📍
Updated Business Mailing Address February 15, 2016

Registered at 5850 E STILL CIR, MESA, AZ 852063618 (Tel: 4802196000)

👤
Provider Name / Credentials Updated February 15, 2016

Recorded as JACOB JOHNSON, D.M.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) February 15, 2016

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration February 15, 2016

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1982063228
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 15, 2016
Last Update: June 21, 2021
Sole Proprietor: Yes

Mailing Address

4930 E Lake Mary Blvd

Sanford, FL 327715003

Phone: 4073228645

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.