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

Jacob L Revercomb, DDS

Individual provider General Practice Dentistry · NPI 1700987674

Jacob L Revercomb, DDS is a General Practice Dentistry in Manlius, New York. Licensed in New York. Registered with an NPI since 2006.

Licensed in
NY
In the registry since
2006
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.

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Practice location Address checks out

8076 Cazenovia Rd
Manlius, NY 13104
Phone: (315) 682-8400
Fax: (315) 682-2602
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence 048833 (NY)

Record details

NPI number1700987674
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS
Sole proprietorNo
NPI enumeratedSeptember 25, 2006
Last updated in NPPESJuly 8, 2007
Mailing address8076 Cazenovia Rd, Manlius, NY 13104

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