Provider Demographics
NPI:1386289809
Name:STUCKI, JACOB TURNER (DDS, MD)
Entity type:Individual
Prefix:DR
First Name:JACOB
Middle Name:TURNER
Last Name:STUCKI
Suffix:
Gender:M
Credentials:DDS, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 N GRANT ST # 4873
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80203-1859
Mailing Address - Country:US
Mailing Address - Phone:720-523-3103
Mailing Address - Fax:
Practice Address - Street 1:10000 COMMONS ST
Practice Address - Street 2:
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-5501
Practice Address - Country:US
Practice Address - Phone:720-523-3103
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-07
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.002061361223S0112X
OH30.026297122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentist
No1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty