Healthcare Provider Details

I. General information

NPI: 1891603916
Provider Name (Legal Business Name): SHERIDA D JACOBS DMD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4132 ARKWRIGHT RD
MACON GA
31210-1707
US

IV. Provider business mailing address

4132 ARKWRIGHT RD APT SUITE
MACON GA
31210-1707
US

V. Phone/Fax

Practice location:
  • Phone: 478-808-8222
  • Fax: 478-405-7794
Mailing address:
  • Phone: 478-405-7797
  • Fax: 478-405-7794

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. SHERIDA DAWN JACOBS
Title or Position: DENTIST/OWNER
Credential: DMD
Phone: 478-405-7797