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DR. MICHAEL LYNN JACOBSEN DDS
NPI 1053335927
Dentist in Wichita, KS

Active since July 26, 2006Opted out of Medicare · through Jan 1, 2028
1120 S CLIFTON AVE, WICHITA, KS 67218(316) 687-4111(316) 688-1098 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Michael Lynn Jacobsen Dds NPPES

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

DR. MICHAEL LYNN JACOBSEN DDS (NPI 1053335927) is an individual dentist in Wichita, Kansas, licensed in Kansas (6409) and active in the NPI registry since July 2006. He has opted out of Medicare through January 1, 2028.

NPPES Registry Identity

NPI1053335927
Entity TypeIndividualMale
Primary Taxonomy122300000X
Provider Legal NameDR. MICHAEL LYNN JACOBSENCredential: DDS
Location Address1120 S CLIFTON AVEWichita, KS 67218-2913
Mailing Address1120 S Clifton AveWichita, KS 67218-2913 · (316) 687-4111 · Fax (316) 688-1098
Phone(316) 687-4111
Fax(316) 688-1098
Sole ProprietorYes
Enumeration DateJuly 26, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1053335927 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in KS · 6409
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
1120 S CLIFTON AVE, Wichita, KS 67218
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Other Identifiers 1

Medicare UPINU40323KS

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Michael Lynn Jacobsen Dds has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 1, 2026 through January 1, 2028.

Opt-Out Effective DateJanuary 1, 2026
Opt-Out In Effect ThroughJanuary 1, 2028Opt-out affidavits renew automatically every two years unless cancelled

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 Michael Jacobsen's NPI number?

The NPI number for Michael Jacobsen is 1053335927. It was assigned to this individual provider in the NPPES registry on July 26, 2006.

Where is Michael Jacobsen located?

Michael Jacobsen practices at 1120 S Clifton Ave, Wichita, KS 67218. The listed phone number is (316) 687-4111.

What is Michael Jacobsen's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Michael Jacobsen enrolled in Medicare?

No. Michael Jacobsen has opted out of Medicare through January 1, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Michael Jacobsen was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years 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.