Provider Demographics
NPI:1649374877
Name:JACOBS, LEYVEE CABANILLA (DDS, MSD)
Entity type:Individual
Prefix:DR
First Name:LEYVEE
Middle Name:CABANILLA
Last Name:JACOBS
Suffix:
Gender:F
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40400 ANN ARBOR RD E
Mailing Address - Street 2:STE 204A
Mailing Address - City:PLYMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48170-6615
Mailing Address - Country:US
Mailing Address - Phone:734-459-4077
Mailing Address - Fax:
Practice Address - Street 1:40400 ANN ARBOR RD E
Practice Address - Street 2:STE 204A
Practice Address - City:PLYMOUTH
Practice Address - State:MI
Practice Address - Zip Code:48170-6615
Practice Address - Country:US
Practice Address - Phone:734-459-4077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-08
Last Update Date:2014-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010182711223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics