Jared Jasicki

Dentist · Longview, TX

Individual Active NPI

NPI number 1235068966

Practice location

3052 N Eastman Rd Ste 108
Longview, TX 75605-5013
Phone
(903) 686-1905

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NPI record

NPI
1235068966
Entity type
Individual (Type 1)
Enumeration date
May 18, 2026
Last updated
July 6, 2026
Certified
July 6, 2026
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Dentist Primary 122300000X 42529 TX

Mailing address

1121 E Hawkins Pkwy Apt 5212
Longview, TX 75605-0125

Other practice locations (2)

  • 8942 S Broadway Ave Ste 128, Tyler, TX 75703-5443 · (903) 405-1552
  • 3873 Hwy 64 W, Tyler, TX 75704-6925 · (903) 525-6983

About Jared Jasicki

Jared Jasicki is a healthcare provider registered in the NPI registry with the primary taxonomy Dentist (code 122300000X). The practice location is 3052 N Eastman Rd Ste 108, Longview, TX 75605-5013. The NPI number 1235068966 was assigned on May 18, 2026 and the record was last updated on July 6, 2026.

Jared Jasicki lists a license in the registry: #42529 (TX) for Dentist. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Jared Jasicki?

The NPI number is 1235068966.

What is the phone number of Jared Jasicki?

The phone number listed for the practice location is (903) 686-1905.

Where is Jared Jasicki located?

3052 N Eastman Rd Ste 108, Longview, TX 75605-5013.

What is the taxonomy code for Jared Jasicki?

The primary taxonomy code is 122300000X – Dentist.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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