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STACY JACOB DMD
NPI 1275150013
Dentist - General Practice in Lakewood, OH

Active since June 27, 2020
15711 MADISON AVE STE 104, LAKEWOOD, OH 44107(216) 228-7950(216) 228-7951 Get Directions Write a Review

NPPES record last updated: June 27, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Stacy Jacob Dmd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

STACY JACOB DMD (NPI 1275150013) is an individual general practice provider in Lakewood, Ohio, licensed in Ohio (30.026177) and active in the NPI registry since June 2020.

NPPES Registry Identity

NPI1275150013
Entity TypeIndividualFemale
Primary Taxonomy1223G0001X
Provider Legal NameSTACY JACOBCredential: DMD
Location Address15711 MADISON AVE STE 104Lakewood, OH 44107-5655
Mailing Address15711 Madison Ave Ste 104Lakewood, OH 44107-5655 · (216) 228-7950 · Fax (216) 228-7951
Phone(216) 228-7950
Fax(216) 228-7951
Sole ProprietorYes
Enumeration DateJune 27, 2020
NPPES CertifiedJune 27, 2020
✔ NPI 1275150013 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in OH · 30.026177
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.
15711 MADISON AVE STE 104, Lakewood, OH 44107
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Other Identifiers 1

Other30.026177OH · Dental Licence

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and more.Insurance ›

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. URBAN MICHAEL PICARD DDS
Dentist (Oral and Maxillofacial Surgery)
15711 MADISON AVE STE 104
LAKEWOOD, OH 44107
Cuyahoga County (216) 228-9000
DR. CONNOR KILANDER DMD
Dentist
15711 MADISON AVE STE 104
LAKEWOOD, OH 44107
Cuyahoga County (216) 228-7950
JUSTIN MACKERT DMD
Dentist (General Practice)
15711 MADISON AVE STE 104
LAKEWOOD, OH 44107
Cuyahoga County (440) 823-3175
ASSOCIATES IN DENTISTRY LLC
Dentist
15711 MADISON AVE STE 104
LAKEWOOD, OH 44107
Cuyahoga County (440) 899-7950

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Stacy Jacob's NPI number?

The NPI number for Stacy Jacob is 1275150013. It was assigned to this individual provider in the NPPES registry on June 27, 2020.

Where is Stacy Jacob located?

Stacy Jacob practices at 15711 Madison Ave Ste 104, Lakewood, OH 44107. The listed phone number is (216) 228-7950.

What is Stacy Jacob's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

What insurance does Stacy Jacob accept?

Health plans from Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and MedMutual list Stacy Jacob as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Stacy Jacob was last updated on June 27, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.