Eric Stefan Jacobson, D.M.D.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

9750 Issued in KY

Practice address

1006 Ace Dr
Berea, KY 40403-1327

Phone

(859) 286-6999

Fax

(859) 406-1333

NPI assigned

Jun 2, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Kentucky Dental Anesthesia Services

  • Anesthesiology Physician
  • Berea, KY
  • NPI 1013696723
  NPD Authorized official
• Pinnacle Pediatric Dentistry, PLLC

  • Pediatric Dentistry
  • Lexington, KY
  • NPI 1174453278
  NPD Authorized official
• Pinnacle Pediatric Dentistry, PLLC

  • Pediatric Dentistry
  • Berea, KY
  • NPI 1528714615
  NPD Authorized official

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

{
    "created_epoch": "1464825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779235200000",
    "number": "1205284098",
    "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": "859-286-6999",
            "fax_number": "859-406-1333"
        },
        {
            "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": "859-286-6999",
            "fax_number": "859-406-1333"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1722 Sharkey Way",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405112028",
            "country_code": "US",
            "telephone_number": "859-788-7123",
            "fax_number": "859-406-1333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "ERIC",
        "middle_name": "STEFAN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-02",
        "last_updated": "2026-05-20",
        "certification_date": "2026-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "KY",
            "license": "9750",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "9750",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Judith O. Hudson, LCSW
• Nathan Hudson, PHARMD
• Megan Anne Hundley, CCC-SLP
• Brenda J Huser, D.C.
• Vilena Isaacs
• Stephanie James
• Jane E Mecham Speech Therapy
• Jason B. Howard, O.D. L.L.C.
• Jennifer Eich Counseling LLC
• Angela Marie Johnson, PHARMD

• Pediatric Dentistry in Berea, KY
• Providers in Berea, KY by specialty
• Pediatric Dentistry in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.