NPI age
6 years
Enumerated 2020-03-19
● Active
Type 1 · Individual
Jake Kuruvilla Philip
Philip is 1 of 1092 dentist providers in Dallas and 1 of 15661 in Texas.
Primary specialty
Dentist
Plus 1 subspecialty
Licensed in
IL
1 state
Status
Active
No deactivations on record
Last NPPES update
2020-08-03
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 15661 active dentist providers in Texas.
NPI age
6 years
↓ 8 yr below median (14 yr)
State licenses
1 state
5% of peers hold multiple states
Subspecialties
1
In the 13% of peers with subspecialties
NPI lifetime · 2020 → 2026
2020-03Enumerated in NPPES
2020
2026
Where they practice
Practice location
4500 S Lancaster Rd
Dallas, TX 752167167
Mailing address
3151 Glenway Dr
Northbrook, IL 600627507
Additional practice locations
1 secondary location on file with NPPES.
Location 2
1801 W Wisconsin Ave
Milwaukee, WI 532332186
Specialties
-
Dentist PrimaryA 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.
-
Student in an Organized Health Care Education/Training ProgramAn individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (IL) | 019.032813 | DENTAL LICENSURE |
Practice context
Part of a multi-provider practice. 1026 other active providers share this practice address in NPPES.
Recently enumerated nearby: 5 new dentist providers have been added in Dallas in the last 180 days.
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Request a quote →How to verify this provider
- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.