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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

JACOB FORTENBERRY DMD
NPI 1003657651
Dentist - Endodontics in Lutz, FL

Active since June 05, 2024
17661 HARPERS RUN, LUTZ, FL 33558(601) 278-0923 Get Directions Write a Review

NPPES record last updated: August 10, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Aug 10, 2026, Sep 24, 2024, Jun 5, 2024 (3 updates tracked since 2024).

About Jacob Fortenberry Dmd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACOB FORTENBERRY DMD (NPI 1003657651) is an individual endodontics provider in Lutz, Florida, licensed in Florida (32429) and active in the NPI registry since June 2024. He maintains a secondary practice location in Madison.

NPPES Registry Identity

NPI1003657651
Entity TypeIndividualMale
Primary Taxonomy1223E0200X
Provider Legal NameJACOB FORTENBERRYCredential: DMD
Location Address17661 HARPERS RUNLutz, FL 33558-5737
Mailing Address502 S Fremont Ave Apt 1127Tampa, FL 33606-2015 · (601) 278-0923
Phone(601) 278-0923
Sole ProprietorNo
Enumeration DateJune 5, 2024
Last NPPES UpdateAugust 10, 20263 updates tracked since enumeration
NPPES CertifiedAugust 10, 2026
✔ NPI 1003657651 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentist · EndodonticsDental Providers
Taxonomy Code1223E0200X
License✔ Licensed in FL · 32429
Definition
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.
Also ListedDentistTaxonomy 122300000X · License 4466-24 (MS)
17661 HARPERS RUN, Lutz, FL 33558
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Secondary Practice Location 1

Location 17731 Old Canton Rd Ste AMadison, MS 39110-6115 · Phone (601) 278-0923

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Sheld, Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana and more.Insurance ›

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jacob Fortenberry's NPI number?

The NPI number for Jacob Fortenberry is 1003657651. It was assigned to this individual provider in the NPPES registry on June 5, 2024.

Where is Jacob Fortenberry located?

Jacob Fortenberry practices at 17661 Harpers Run, Lutz, FL 33558. The listed phone number is (601) 278-0923.

What is Jacob Fortenberry's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Endodontics, with taxonomy code 1223E0200X.

What insurance does Jacob Fortenberry accept?

Health plans from Anthem Blue Cross and Blue Sheld, Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas list Jacob Fortenberry as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jacob Fortenberry was last updated on August 10, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.