DR. JACOB MANGUM DDS
NPI 1508751454
Dentist in Ann Arbor, MI

Q: What is Jacob Mangum's NPI number?

The NPI number for Jacob Mangum is 1508751454. It was assigned to this individual provider in the NPPES registry on June 11, 2025.

Q: What is Jacob Mangum's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Jacob Mangum was last updated on June 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months 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.

Active since June 11, 2025

2215 FULLER RD, ANN ARBOR, MI 48105(734) 769-7100 Get Directions Write a Review

NPPES record last updated: June 11, 2025. Verified against the NPPES registry weekly; last sync: August 23, 2026.

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About Dr. Jacob Mangum Dds NPPES

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

DR. JACOB MANGUM DDS (NPI 1508751454) is an individual dentist in Ann Arbor, Michigan, licensed in Michigan (2901602527) and active in the NPI registry since June 2025. He maintains a secondary practice location in Ann Arbor.

NPPES Registry Identity

NPI1508751454

Entity TypeIndividualMale

Primary Taxonomy122300000X

Provider Legal NameDR. JACOB MANGUMCredential: DDS

Location Address2215 FULLER RDAnn Arbor, MI 48105-2303

Mailing Address262 Longford DrGranville, OH 43023-9282 · (740) 755-5725

Phone(734) 769-7100

Sole ProprietorNo

Enumeration DateJune 11, 2025

NPPES CertifiedJune 11, 2025

✔ NPI 1508751454 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

License✔ Licensed in MI · 2901602527

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.

2215 FULLER RD, Ann Arbor, MI 48105

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Secondary Practice Location 1

Location 11500 E Medical Center DrAnn Arbor, MI 48109-5000 · Phone (734) 936-4000

Other Providers at the Same Location NPPES 20

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

MS. CONSTANCE LAROSA RN

Registered Nurse

2215 FULLER RD
ANN ARBOR, MI 48105

Washtenaw County (734) 769-7100

THOMAS F CURRAN

Anesthesiology

2215 FULLER RD
ANN ARBOR, MI 48105

Washtenaw County (734) 845-5342

MRS. NICHELLE BOWMAN RN

Registered Nurse

2215 FULLER RD, RADIATION ONCOLOGY 114B
ANN ARBOR, MI 48105

Washtenaw County (734) 845-3914

MRS. CAREY ANN MICHEL RN

Registered Nurse

2215 FULLER RD
ANN ARBOR, MI 48105

Washtenaw County (734) 222-4230

JACQUELYN VANZILE LPCC

Counselor (Mental Health)

2215 FULLER RD
ANN ARBOR, MI 48105

Washtenaw County (734) 769-7100

CARRIE JO HERNANDEZ RN

Registered Nurse

2215 FULLER RD
ANN ARBOR, MI 48105

Washtenaw County (734) 845-5598

ERIC PATTERSON PTA

Physical Therapy Assistant

2215 FULLER RD
ANN ARBOR, MI 48105

Washtenaw County (734) 845-3829

MS. AMIE RICHARDSON

Physical Therapy Assistant

2215 FULLER RD
ANN ARBOR, MI 48105

Washtenaw County (734) 769-7100

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 Mangum's NPI number?

The NPI number for Jacob Mangum is 1508751454. It was assigned to this individual provider in the NPPES registry on June 11, 2025.

Where is Jacob Mangum located?

Jacob Mangum practices at 2215 Fuller Rd, Ann Arbor, MI 48105. The listed phone number is (734) 769-7100.

What is Jacob Mangum's specialty?

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

When was this NPI record last updated?

The NPPES record for Jacob Mangum was last updated on June 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months 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.