Stacy Jacob

DMD | Dentist



  
  15711 Madison Ave Ste 104, Lakewood
  Ohio, 44107-5655

  216-228-7950    216-228-7951 Maps & Directions
Stacy Jacob is a Lakewood, Ohio based Dentist who is specialized in General Practice Dentistry. She does not accept the Medicare-approved amount. Patients will be billed for the treatment. Active license number of Stacy Jacob is 30.026177 for General Practice Dentistry in Ohio. Her current practice location is 15711 Madison Ave Ste 104, Lakewood. Patients can reach her at 216-228-7950.
Stacy Jacob is the primary dental care provider for patients of all ages. She is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Complete Profile:
Stacy Jacob speciality, credentials, practice address, contact phone number and fax are as below. Patients can directly walk in or can call on the below given phone number for appointment.
Name: Stacy Jacob
Specialization: Dentist
Gender:Female
Credentials: DMD
Accepts Medicare Assignment:No
Practice Address:15711 Madison Ave Ste 104, Lakewood,
Ohio, 44107-5655
Phone:216-228-7950
Fax:216-228-7951
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
NPI Number: 1275150013
NPI Enumeration Date: 27 Jun, 2020
NPI Last Update On: 27 Jun, 2020

Medical Licenses:
Doctors can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Stacy Jacob are as mentioned below.
License NumberSpecializationStateStatus
30.026177General Practice Dentistry OhioPrimary
Other Medical Identifiers:
Other legacy medical identifiers associated with Stacy Jacob such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
IdentifierTypeStateIssuer
30.026177OtherOhioDENTAL LICENCE
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address: 15711 Madison Ave Ste 104,
Lakewood, Ohio
Zip: 44107-5655
Phone Number: 216-228-7950
Fax Number: 216-228-7951
Patients can reach Stacy Jacob at 15711 Madison Ave Ste 104, Lakewood, Ohio or can call to book an appointment on 216-228-7950. Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 09 December, 2024.

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