Provider Demographics
NPI:1861216780
Name:CHAIM ALEN JAKOB PA
Entity type:Organization
Organization Name:CHAIM ALEN JAKOB PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHAIM ALEN
Authorized Official - Middle Name:
Authorized Official - Last Name:JAKOB
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:917-535-3679
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:917-535-3679
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:917-535-3679
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-08
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty