Scott Jacks, DDS, Inc

Dentist · Baldwin Park, CA

Organization Active NPI

NPI number 1336542851

Practice location

4138 Maine Ave Ste M2
Baldwin Park, CA 91706-3302
Phone
(323) 564-2444
Fax
(323) 923-1088

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NPI record

NPI
1336542851
Entity type
Organization (Type 2)
Enumeration date
September 29, 2014
Last updated
November 25, 2015
Organization subpart
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Dentist Primary 122300000X 31668 CA
Pediatric Dentistry 1223P0221X 24464 CA
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 31668 CA

Mailing address

4444 Tweedy Blvd
South Gate, CA 90280-6304
Phone
(323) 564-2444
Fax
(323) 923-1088

Authorized official

Name
Dr. Jerry David Minsky, D.D.S.
Title
President
Phone
(323) 564-2444

Other names

  • Children's Dental Group

About Scott Jacks, DDS, Inc

Scott Jacks, DDS, Inc is a healthcare organization registered in the NPI registry with the primary taxonomy Dentist (code 122300000X). The practice location is 4138 Maine Ave Ste M2, Baldwin Park, CA 91706-3302. The NPI number 1336542851 was assigned on September 29, 2014 and the record was last updated on November 25, 2015.

Scott Jacks, DDS, Inc lists 3 licenses in the registry: #31668 (CA) for Dentist; #24464 (CA) for Pediatric Dentistry; #31668 (CA) for Orthodontics and Dentofacial Orthopedics Dentistry. License numbers are self-reported to NPPES; verify them with the state licensing board.

The authorized official for this organization is Dr. Jerry David Minsky, D.D.S., President.

Frequently asked questions

What is the NPI number of Scott Jacks, DDS, Inc?

The NPI number is 1336542851.

What is the phone number of Scott Jacks, DDS, Inc?

The phone number listed for the practice location is (323) 564-2444.

Where is Scott Jacks, DDS, Inc located?

4138 Maine Ave Ste M2, Baldwin Park, CA 91706-3302.

What is the taxonomy code for Scott Jacks, DDS, Inc?

The primary taxonomy code is 122300000X – Dentist; 2 more listed above.

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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