Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1902476682 Individual Practitioner Male Practitioner

Dr. Jacob Groom , DMD

Dentist - General Practice • Vancouver, WA

Professional Overview & Biography Verified Profile Summary

Dr. Jacob Groom, DMD is a registered healthcare professional specializing in Dentist - General Practice in Vancouver, WA. Practice services are available at 7012 NE 40TH ST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

7012 Ne 40th St

Vancouver, WA 986613052

Telephone 3602545254
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Vancouver, WA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 21.3 Yrs
Regional Practice Density
158 Specialists

Practicing in Vancouver, WA (3345 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: 2025-04-11
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License WA DE61203036

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

3 Associated Practitioners
Dr. Robert Janisse , DDS

Dentist - General Practice

NPI 1194834895

Doctor of Dental Surgery

Dr. Roger Wendel , DMD

Dentist - General Practice

NPI 1861582991

Doctor of Dental Medicine

NPI 1912236092

Doctor of Dental Surgery

Career & Practice History Timeline

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

9 Historical Events
📍
Updated Practice Location April 11, 2025

Registered at 7012 NE 40TH ST, VANCOUVER, WA 986613052 (Tel: 3602545254)

📍
Updated Business Mailing Address April 11, 2025

Registered at 4530 NW WALDEN ST, CAMAS, WA 986079130 (Tel: 5037026532)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 11, 2025

Dentist (License #DE61203036 in WA)

NPI Profile Active June 25, 2021

NPI status registered as active in NPPES database

📍
Updated Practice Location June 25, 2021

Registered at 13908 SE STARK ST STE B, PORTLAND, OR 972332161 (Tel: 5032534979)

📍
Updated Business Mailing Address June 25, 2021

Registered at 13908 SE STARK ST STE B, PORTLAND, OR 972332161 (Tel: 5032534979)

👤
Provider Name / Credentials Updated June 25, 2021

Recorded as JACOB GROOM, DMD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 25, 2021

Dentist (License #D11457 in OR)

🟢
Initial NPI Registration & Enumeration June 25, 2021

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: 1902476682
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 25, 2021
Last Update: April 11, 2025
Sole Proprietor: Yes

Mailing Address

4530 Nw Walden St

Camas, WA 986079130

Phone: 5037026532

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.