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Deactivated NPI 1740409986 Deactivated / Inactive NPI Male Practitioner

Dr. Wayne Steven Jacobson , DDS

Dentist - General Practice • Lisle, IL

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Wayne Jacobson has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date April 25, 2007
NPI Deactivation Date November 06, 2025
Total Practice Duration ~18 Years of Practice (2007 – 2025)

Professional Overview & Biography Verified Profile Summary

Dr. Wayne Jacobson, DDS was a registered Dentist - General Practice practicing in Lisle, IL. Throughout an active medical career spanning 18 years, Dr. Jacobson provided care at the practice location at 1440 MAPLE AVE until profile deactivation on 2025-11-06.

Practice Location & Contact Primary Location

Practice Address

1440 Maple Ave
3a

Lisle, IL 605324134

Telephone 6309639280
Associated Practice Facility / Clinic
🏢 Wayne S Jacobson Dds Ltd Facility NPI 1871712984

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Lisle, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 18.0 Yrs
Regional Practice Density
19 Specialists

Practicing in Lisle, IL (5581 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

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License IL 19015131

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.

Practice Associates & Co-Workers

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

1 Associated Practitioners
NPI 1609088418

Doctor of Dental Surgery

Career & Practice History Timeline

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

7 Historical Events
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NPI Profile Deactivated November 06, 2025

Record deactivated on November 06, 2025

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 1440 MAPLE AVE, 3A, LISLE, IL 605324134 (Tel: 6309639280)

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Updated Business Mailing Address July 08, 2007

Registered at 1440 MAPLE AVE, 3A, LISLE, IL 605324134 (Tel: 6309639280)

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Provider Name / Credentials Updated July 08, 2007

Recorded as WAYNE JACOBSON, DDS

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist (License #19015131 in IL)

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Initial NPI Registration & Enumeration April 25, 2007

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: 1740409986
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 25, 2007
Last Update: July 08, 2007
Deactivation Date: November 06, 2025

Mailing Address

1440 Maple Ave, 3a

Lisle, IL 605324134

Phone: 6309639280

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.