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DR. JACOB NICOLAS TICE DMD
NPI 1174190672
Dentist in San Diego, CA

Active since June 04, 2021PECOS Enrolled
1975 GARNET AVE STE E, SAN DIEGO, CA 92109(858) 866-0808 Get Directions Write a Review

NPPES record last updated: June 4, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Jacob Nicolas Tice Dmd NPPES

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

DR. JACOB NICOLAS TICE DMD (NPI 1174190672) is an individual dentist in San Diego, California, licensed in California (DDS106187) and active in the NPI registry since June 2021. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1174190672
Entity TypeIndividualMale
Primary Taxonomy122300000X
Provider Legal NameDR. JACOB NICOLAS TICECredential: DMD
Location Address1975 GARNET AVE STE ESan Diego, CA 92109-3594
Mailing Address7117 El Viento WayBuena Park, CA 90620-2510 · (480) 302-1467
Phone(858) 866-0808
Sole ProprietorYes
Enumeration DateJune 4, 2021
NPPES CertifiedJune 4, 2021
✔ NPI 1174190672 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in CA · DDS106187
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.
1975 GARNET AVE STE E, San Diego, CA 92109
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Accepted Insurance

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

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Jacob Nicolas Tice Dmd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92109 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$94.87 typical visit price
range $62.10 – $184.71
Typical copayment $23.71 (range $15.52 – $46.17)
Most-billed visit code 99203
Established Patient
$76.87 typical visit price
range $20.62 – $151.42
Typical copayment $19.21 (range $5.15 – $37.85)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. CLIFFORD GEE DMD
Dentist
1975 GARNET AVE STE E
SAN DIEGO, CA 92109
San Diego County (858) 866-0808
DR. HEMANT SACHDEVA DDS
Dentist (General Practice)
1975 GARNET AVE STE E
SAN DIEGO, CA 92109
San Diego County (858) 866-0808
NAMANA RAO DDS
Dentist (General Practice)
1975 GARNET AVE STE E
SAN DIEGO, CA 92109
San Diego County (858) 866-0808
MINH B PHAM DENTAL CORPORATION
Dentist
1975 GARNET AVE STE E
SAN DIEGO, CA 92109
San Diego County (858) 866-0808
DR. SHBEENA SHAH DDS
Dentist (General Practice)
1975 GARNET AVE STE E
SAN DIEGO, CA 92109
San Diego County (858) 866-0808
DR. JASON SHINDO DMD
Dentist
1975 GARNET AVE STE E
SAN DIEGO, CA 92109
San Diego County (858) 866-0808

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 Tice's NPI number?

The NPI number for Jacob Tice is 1174190672. It was assigned to this individual provider in the NPPES registry on June 4, 2021.

Where is Jacob Tice located?

Jacob Tice practices at 1975 Garnet Ave Ste E, San Diego, CA 92109. The listed phone number is (858) 866-0808.

What is Jacob Tice's specialty?

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

Is Jacob Tice enrolled in Medicare?

Yes. Jacob Tice is registered in the Medicare PECOS enrollment system.

What insurance does Jacob Tice accept?

Health plans from Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas and 4 other insurers list Jacob Tice 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 Tice was last updated on June 4, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.