Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
STACY JACOB, DMD
Active Sole ProprietorSTACY JACOB, DMD is a General Dentistry healthcare provider located in LAKEWOOD, Ohio. NPI 1275150013 is currently active in the NPPES registry. Verify at CMS.
General Dentistry · LAKEWOOD, OH
Registration Details
- NPI Number
- 1275150013
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jun 27, 2020 (6.1432339879302 yrs)
- Last Updated
- Jun 27, 2020
- License
-
30.026177 (OH)
- Sole Proprietor
- Yes
Practice Information
- Address
-
15711 MADISON AVE STE 104LAKEWOOD, OH, 441075655Browse OH providers · Browse ZIP 44107
- Phone
- 2162287950
- Fax
- 2162287951
- Primary Specialty
-
General Dentistry
1223G0001X
Other General Dentistry Providers in LAKEWOOD, OH
| Name | Credential | NPI |
|---|---|---|
| DR. GARY ROGER HERMANN | D.D.S. | 1457450264 |
| DR. NICOLE L COCHRAN | DDS | 1316028145 |
| DR. DIANNE MARIE MCDONALD | D.D.S. | 1427120419 |
| DR. RAINARD MICHAEL BEER | DDS | 1740346634 |
| DR. MARK ROBERT LOPER | D.D.S. | 1255489449 |
| DR. GREGORY P DEVOR | D.D.S. | 1265588008 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.