Provider Demographics
NPI:1487055661
Name:JAKOB, CHAIM ALEN (DMD)
Entity type:Individual
Prefix:DR
First Name:CHAIM ALEN
Middle Name:
Last Name:JAKOB
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:DR
Other - First Name:CHAIM
Other - Middle Name:
Other - Last Name:JAKOB
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:7301 W PALMETTO PARK RD STE 205C
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-3456
Mailing Address - Country:US
Mailing Address - Phone:516-990-3636
Mailing Address - Fax:
Practice Address - Street 1:7301 W PALMETTO PARK RD STE 205C
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-3456
Practice Address - Country:US
Practice Address - Phone:561-990-3636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-08
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0576021223E0200X
FLDN265661223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics