Individual provider · Type 1 NPI

Theodore Edward Jacobson, DMD

Oral and Maxillofacial Surgery (Dentist) · Fresno, CA

NPI number 1417649088 Active

Practice location

215 N Fresno St Ste 490
Fresno, CA 93701-2363

Call (559) 459-4191 Map

Specialties and licenses

TaxonomyCodeLicense
Oral and Maxillofacial Surgery (Dentist) Primary 1223S0112XDDS112415 (CA)

Oral and Maxillofacial Surgery (Dentist): The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

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About NPI 1417649088

Theodore Edward Jacobson, DMD's National Provider Identifier is 1417649088, issued on May 23, 2023. The primary taxonomy on file is Oral and Maxillofacial Surgery (Dentist) (1223S0112X), and the practice location is in Fresno, CA. The record was last updated on Feb 2, 2026.