MEDICARE: STEPHEN E JACOBSON DDS PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	18553	MI
2	1223G0001X	General Practice Dentistry	16758	MI
3	1223P0300X	Periodontics	18913	MI
4	1223G0001X	General Practice Dentistry	14257	MI

General Provider Information

NPI Number	:	1518117498
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STEPHEN E JACOBSON DDS PC

Provider Business Mailing Address
First Line	:	39890 W 14 MILE RD
Second Line	:
City	:	WALLED LAKE
State	:	MI
Zip	:	48390-3911
Country	:	US
Telephone Number	:	248-624-8090
Fax Number	:	248-624-8288

Provider Business Practice Location Address
First Line	:	39890 W 14 MILE RD
Second Line	:
City	:	COMMERCE TOWNSHIP
State	:	MI
Zip	:	48390-3911
Country	:	US
Telephone Number	:	248-624-8090
Fax Number	:	248-624-8288

Authorized Official
Title or Position	:	DENTIST
Name	:	DR. STEPHEN E JACOBSON
Credential	:	D.D.S, P.C.
Telephone Number	:	248-624-8090

Provider Enumeration Date	:	09/26/2008
Last Update Date	:	07/28/2022

Similar Medicare Providers

1689786980 — DR. PAULA A TAYLOR DDS
Practice Location Address:

39890 W 14 MILE RD
COMMERCE TOWNSHIP, MI
48390-3911

Practice Phone: 248-624-8090
Practice Fax:

1548390230 — MEENA KISHAN SABNIS D.D.S.
Practice Location Address:

39890 W 14 MILE RD
COMMERCE TOWNSHIP, MI
48390-3911

Practice Phone: 248-624-8090
Practice Fax: 248-624-8288

1396555603 — LIFETIME DENTAL CARE OF MICHIGAN, P.C.
Practice Location Address:

39890 W 14 MILE RD
COMMERCE TOWNSHIP, MI
48390-3911

Practice Phone: 248-624-8090
Practice Fax:

1528077435 — STEPHEN ERIC JACOBSON D.D.S. PC
Practice Location Address:

39890 W 14 MILE RD.
WALLED LAKE, MI
48390-3911

Practice Phone: 248-624-8090
Practice Fax: 248-624-8288

1164941043 — YMCA OF THE JERSEY SHORE
Practice Location Address:

3911 HERBERTSVILLE RD
WALL TOWNSHIP, NJ
08724-0904

Practice Phone: 732-290-9040
Practice Fax: 732-566-0433

1033168448 — DR. JIM ALLISON CHAMBERS PH.D.
Practice Location Address:

115 N COMMERCE ST
GAINESVILLE, TX
76240-3911

Practice Phone: 940-665-8056
Practice Fax: 940-665-8057

Directions to “STEPHEN E JACOBSON DDS PC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.