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

Jake Kuruvilla Philip

Individual provider General Practice Dentistry · NPI 1659907871

Jake Kuruvilla Philip is a General Practice Dentistry in Dallas, Texas. Works from 2 locations. Licensed in Illinois.

Licensed in
IL
In the registry since
2020
Specialties on file
2
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Practice location Address checks out

4500 S Lancaster Rd
Dallas, TX 75216-7167
Phone: (214) 857-1082
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1801 W Wisconsin Ave, Milwaukee, WI 53233-2186 — (414) 288-6790

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence 019.032813 (IL)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1659907871
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMarch 19, 2020
Last updated in NPPESAugust 3, 2020
Certification dateAugust 3, 2020
Mailing address3151 Glenway Dr, Northbrook, IL 60062-7507

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