Individual provider Active NPI

Jacob Kobi Stern, DMD, MSC

  • Periodontics
  • Augusta, GA
National Provider Identifier
1871732081
Registry record updated Feb 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
DNF000348 Issued in GA
Practice address
1430 John Wesley Gilbert Drive
Augusta, GA 30912-1001
Phone
(706) 721-9633
Fax
(706) 721-0266
NPI assigned
Feb 11, 2009
Last updated
Feb 19, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 0401416194 VA
Periodontics 1223P0300X DNCS000313 GA
Periodontics 1223P0300X DNF000348 GA Primary

Addresses

Primary practice location

1430 John Wesley Gilbert Drive
Augusta, GA 30912-1001

Mailing address

1430 John Wesley Gilbert Drive GC-1012
Augusta, GA 30912-0004
Phone (706) 721-7913

Other identifiers 2

IdentifierTypeStateIssuer
362943601AMedicaidGA
ZG0348MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20160212002105 GA Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 4183928054

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DNCS000313GAMDPeriodontist
DNF000348GAMDPeriodontist
0401416194VAMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Au Dental Associates CurrentSince Aug 1, 1996 Accepting new patients
Au Surgery Center, LLC CurrentSince Mar 7, 2021 Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1234310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771459200000",
    "number": "1871732081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 JOHN WESLEY GILBERT DRIVE GC-1012",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309120004",
            "telephone_number": "706-721-7913",
            "fax_number": "706-723-0274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 JOHN WESLEY GILBERT DRIVE",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309121001",
            "telephone_number": "706-721-9633",
            "fax_number": "706-721-0266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STERN",
        "first_name": "JACOB",
        "middle_name": "KOBI",
        "name_prefix": "Dr.",
        "credential": "DMD, MSC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-11",
        "last_updated": "2026-02-19",
        "certification_date": "2026-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "VA",
            "license": "0401416194",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "GA",
            "license": "DNCS000313",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "GA",
            "license": "DNF000348",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "362943601A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZG0348",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

Verify at the official NPI Registry.