Provider Demographics
NPI:1043746084
Name:HAMBY, JACOB W (DMD)
Entity type:Individual
Prefix:
First Name:JACOB
Middle Name:W
Last Name:HAMBY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 W 32ND ST STE C
Mailing Address - Street 2:
Mailing Address - City:JOPLIN
Mailing Address - State:MO
Mailing Address - Zip Code:64804-2528
Mailing Address - Country:US
Mailing Address - Phone:417-623-8232
Mailing Address - Fax:417-624-4426
Practice Address - Street 1:620 W 32ND ST STE C
Practice Address - Street 2:
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64804-2528
Practice Address - Country:US
Practice Address - Phone:417-623-8232
Practice Address - Fax:417-623-4426
Is Sole Proprietor?:No
Enumeration Date:2017-05-11
Last Update Date:2025-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20200057601223G0001X
WI1001606-151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice