Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jacob Johnson, DMD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1982063228

Jacob Johnson, DMD is a Student in an Organized Health Care Education/Training Program in Sanford, Florida. Practices as a sole proprietor and works from 2 locations. Licensed in Florida.

Licensed in
FL
In the registry since
2016
Specialties on file
2
What do these letters mean?
DMD — Doctor of Dental Medicine
A dentist. Identical training and licensing to a DDS.

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Practice location Address checks out

4930 E Lake Mary Blvd
Sanford, FL 32771-5003
Phone: (407) 322-8645
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 5850 E Still Cir, Mesa, AZ 85206-3618 — (480) 219-6000

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence HAD110 (FL)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1982063228
Entity typeIndividual (Type 1)
GenderMale
Credentials DMD
Sole proprietorYes
NPI enumeratedFebruary 15, 2016
Last updated in NPPESJune 21, 2021
Certification dateJune 21, 2021
Mailing address4930 E Lake Mary Blvd, Sanford, FL 32771-5003

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