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 Number | Specialization | State | Status | |
| 30.026177 | General Practice Dentistry | Ohio | Primary | |
Other Medical Identifiers:
Other legacy medical identifiers associated with Stacy Jacob such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 30.026177 | Other | Ohio | DENTAL LICENCE |
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.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on
08 December, 2025.