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Stacy Jacob, DMD
General Practice Dentistry in Lakewood, Ohio
NPI 1275150013

Stacy Jacob is a General Practice Dentistry based in Lakewood, OH and is specialized in General Practice. Stacy Jacob practices in Lakewood, OH and has the professional credentials of DMD. The NPI Number for Stacy Jacob is 1275150013 and holds a License No. 30.026177 (Ohio).

The current practice location address for Stacy Jacob is 15711 Madison Ave Ste 104, Lakewood, OH and can be reached out via phone at 216-228-7950 and via fax at 216-228-7951.

Location: 15711 Madison Ave Ste 104, Lakewood, OH, 44107-5655
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1275150013
Provider Name
Stacy Jacob
Credential
DMD
Provider Entity Type
Individual
Gender
Female
Address
15711 Madison Ave Ste 104, Lakewood, OH, 44107-5655
Phone Number
216-228-7950
Fax Number
216-228-7951
Provider Enumeration Date
06/27/2020
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
30.026177 01 OH DENTAL LICENCE
institution
Provider Business Practice Location Address Details
Address
15711 Madison Ave Ste 104
City
Lakewood
State
Ohio
Zip
44107-5655
Phone Number
216-228-7950
Fax Number
216-228-7951
person
Provider Business Mailing Address Details
Address
15711 Madison Ave Ste 104
City
Lakewood
State
Ohio
Zip
44107-5655
Phone Number
216-228-7950
Fax Number
216-228-7951
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
General Practice
Taxonomy
1223G0001X
License No.
30.026177 (Ohio)
Definition
A 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.
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