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Jacob Prows

Dentist - Endodontics β€’ Jacksonville, FL

Active NPI 1366904229 Individual Practitioner Male Practitioner
Practice location in NPPES

11806 Atlantic Blvd Ste 4
Jacksonville, FL 322252968

Call 9049993386 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

11806 Atlantic Blvd Ste 4

Jacksonville, FL 322252968

Telephone 9049993386

Industry payments (Open Payments)

No Open Payments records are listed for this clinician for 2019–2025.

Guide: How to read an Open Payments record

NPI first issued

2019

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Jacksonville and Florida

29 active clinicians are listed under Dentist - Endodontics with a practice address in Jacksonville, FL (510 in Florida).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Jacksonville

0% of these 29 clinicians have the CMS telehealth indicator.

0% of these 29 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2025-10-09
Dentist - Endodontics Primary Specialty

NUCC Taxonomy Code: 1223E0200X

License # reported to NPPES FL DN29907

The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Florida Department of Health Medical Quality Assurance.
Look Up on State Board Site

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

1 listed
NPI 1528636461

Doctor of Dental Surgery

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

10 Historical Events
πŸ“
Updated Business Mailing Address October 09, 2025

Registered at 11806 ATLANTIC BLVD STE 4, JACKSONVILLE, FL 322252968 (Tel: 9049993386)

πŸ“
Updated Practice Location August 05, 2025

Registered at 11806 ATLANTIC BLVD STE 4, JACKSONVILLE, FL 322252968 (Tel: 9548540872)

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) August 05, 2025

Dentist (license number reported to NPPES: FL DN29907)

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) June 25, 2019

Dentist (license number reported to NPPES: SC 9402)

βœ…
NPI Profile Active April 01, 2019

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) April 01, 2019

Registered at NAVAL HOSPITAL BEAUFORT, 1 PINCKNEY BLVD, BUILDING 1, BEAUFORT, SC 29902 (Tel: 8432285600)

πŸ“
Business Mailing Address (Initial Record) April 01, 2019

Registered at NAVAL HOSPITAL BEAUFORT, 1 PINCKNEY BLVD, BOX 6216A, BUILDING 1, BEAUFORT, SC 29902

πŸ‘€
Provider Name / Credentials (Initial Record) April 01, 2019

Recorded as JACOB PROWS

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) April 01, 2019

Student in an Organized Health Care Education/Training Program

🟒
Initial NPI Registration & Enumeration April 01, 2019

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1366904229
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 01, 2019
Last Update: October 09, 2025
Sole Proprietor: No

Other Dentist - Endodontics Specialists in Jacksonville

All Dentist - Endodontics Specialists in Jacksonville

Mailing Address

11806 Atlantic Blvd Ste 4

Jacksonville, FL 322252968

Phone: 9049993386

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.