{"npi":"1194350140","type":"NPI-1","status":"active","name":{"display":"Jacob Itskovich DMD","other":[],"first":"JACOB","last":"ITSKOVICH","credential":"DMD"},"specialty":{"primary_taxonomy":"390200000X","primary_taxonomy_description":"Student in an Organized Health Care Education/Training Program","slug":"student-in-an-organized-health-care-education-training-program","schema_org_specialty":null,"all":[{"code":"390200000X","description":"Student in an Organized Health Care Education/Training Program","primary":true,"state":"CT","license":"12877"}]},"addresses":[{"purpose":"LOCATION","street_1":"263 FARMINGTON AVE","city":"FARMINGTON","state":"CT","postal_code":"060300001","country_code":"US","phone":"8606792000"},{"purpose":"MAILING","street_1":"6855 LEYTONSTONE BLVD","city":"WEST BLOOMFIELD","state":"MI","postal_code":"483221243","country_code":"US","phone":"2483035919"}],"license":{"state":"CT","number":"12877"},"identifiers":[],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20200810001336","type_code":"33-C5","type_desc":"ORDER AND REFERRING ONLY - DENTIST","state":"CT","pac_id":"2668897539"}]},"enumeration_date":"2020-03-10","last_updated":"2020-08-04","_meta":{"source":"NPPES","snapshot_date":"2020-08-04","doc_url":"https://findmynpi.com/api"}}