DR. JACOB ORTH SISOMBATH D.D.S.
NPI 1710154224
Dentist - General Practice in Dallas, TX

Q: What is Jacob Sisombath's NPI number?

The NPI number for Jacob Sisombath is 1710154224. It was assigned to this individual provider in the NPPES registry on May 14, 2008.

Q: What is Jacob Sisombath's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Q: When was this NPI record last updated?

The NPPES record for Jacob Sisombath was last updated on September 13, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.

Active since May 14, 2008PECOS Enrolled

2020 N MASTERS DR, DALLAS, TX 75217(972) 285-2600 Get Directions Write a Review

NPPES record last updated: September 13, 2012. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Dr. Jacob Orth Sisombath D.d.s. NPPES

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

DR. JACOB ORTH SISOMBATH D.D.S. (NPI 1710154224) is an individual general practice provider in Dallas, Texas, licensed in Texas (25064) and active in the NPI registry since May 2008. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1710154224

Entity TypeIndividualMale

Primary Taxonomy1223G0001X

Provider Legal NameDR. JACOB ORTH SISOMBATHCredential: D.D.S.

Location Address2020 N MASTERS DRDallas, TX 75217-3168

Mailing Address2020 N Masters DrDallas, TX 75217-3168 · (972) 285-2600

Phone(972) 285-2600

Sole ProprietorNo

Enumeration DateMay 14, 2008

Last NPPES UpdateSeptember 13, 2012

✔ NPI 1710154224 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

License✔ Licensed in TX · 25064

Definition

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.

2020 N MASTERS DR, Dallas, TX 75217

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections 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 Orth Sisombath D.d.s. 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 75217 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

$88.19 typical visit price

range $57.18 – $172.86

Typical copayment $22.04 (range $14.29 – $43.21)

Most-billed visit code 99203

Established Patient

$71.28 typical visit price

range $18.48 – $141.20

Typical copayment $17.82 (range $4.62 – $35.30)

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 2

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

METROPLEX PEDIATRIC DENTISTRY PLLC

Dentist (Pediatric Dentistry)

2020 N MASTERS DR
DALLAS, TX 75217

Dallas County (469) 297-2989

MY SMILES DENTAL

Dentist

2020 N MASTERS DR, 100
DALLAS, TX 75217

Dallas County (972) 285-2600

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 Sisombath's NPI number?

The NPI number for Jacob Sisombath is 1710154224. It was assigned to this individual provider in the NPPES registry on May 14, 2008.

Where is Jacob Sisombath located?

Jacob Sisombath practices at 2020 N Masters Dr, Dallas, TX 75217. The listed phone number is (972) 285-2600.

What is Jacob Sisombath's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Jacob Sisombath enrolled in Medicare?

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

What insurance does Jacob Sisombath accept?

Health plans from Ambetter Health, Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and Ambetter from Superior HealthPlan and 15 other insurers list Jacob Sisombath 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 Sisombath was last updated on September 13, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.