National Provider Identifier Database

JACOB V LILJENQUIST, DMD – NPI #1508172107
General Practice

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.


Contact Information

JACOB V LILJENQUIST, DMD
1000 N 8TH AVE
POCATELLO, ID83201-5757
Phone: 208-232-3368
Fax: 208-776-5016
Website:
Specialty Taxonomy Code
* General Practice 1223G0001X
Dental Public Health 1223D0001X
Dentist 122300000X

* Indicates primary specialty

NPI Profile & details for JACOB V LILJENQUIST

NPI Number 1508172107
Credentials DMD (Doctor of Medical Dentistry)
Entity Individual
Enumeration date 08/20/2010
Last updated 05/17/2019 - About 7 years ago
Sole proprietor1 No
Identifiers
  • ID License #: D4811
  • UT License #: 7754866-9921
  • WA License #: DE60162914
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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