Kentucky Dental Anesthesia Services

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

Legal business name

KENTUCKY DENTAL ANESTHESIA SERVICES

Practice address

1006 Ace Dr
Berea, KY 40403-1327

Phone

(859) 420-9187

NPI assigned

Jul 12, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Eric Jacobson, DMDNPI 1205284098

Title

Member

Phone

(859) 420-9187

Specialties & licenses 3

Addresses

Other names 1

• Kentucky Dental Anesthesia Services Former legal business name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Eric Stefan Jacobson, D.M.D.

  • Pediatric Dentistry
  • Berea, KY
  • NPI 1205284098
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1689120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730246400000",
    "number": "1013696723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1006 ACE DR",
            "city": "BEREA",
            "state": "KY",
            "postal_code": "404031327",
            "telephone_number": "859-420-9187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1006 ACE DR",
            "city": "BEREA",
            "state": "KY",
            "postal_code": "404031327",
            "telephone_number": "859-420-9187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENTUCKY DENTAL ANESTHESIA SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-12",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A",
        "authorized_official_last_name": "JACOBSON",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "859-420-9187",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kentucky Dental Anesthesia Services",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Kentucky Dental Anesthesia Services",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Emily Louise Jones
• Melissa Jane Jones, D.M.D.
• Patrick Anthony Kelleher, MD
• Maxine Lynn Keller, LCADC, CADC
• Louis Rhett Kenny, D.C.
• Kentucky Hospice Network
• Kentucky Institute for Eye Health & Surgery
• Gary E King, OD
• Sarah Kaitlin King, O.D.
• Kimberly J Kirby

• Anesthesiology Physician in Berea, KY
• Providers in Berea, KY by specialty
• Anesthesiology Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.