Austin Joly Jacob, DMD is a
Dentist based in Riverside, New Jersey. Austin Joly Jacob is licensed to practice in New Jersey (license number 22DI02940800) and his current practice location is
123 S Pavilion Ave, Riverside, New Jersey. He can be reached at his office (for appointments etc.) via phone at
(856) 393-8510.
NPI number for Austin Joly Jacob is 1790495760 and his current mailing address is 123 S Pavilion Ave, Riverside, New Jersey. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1790495760.
Healthcare Provider's Profile
| Full Name | Austin Joly Jacob |
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| Gender | Male |
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| Speciality | Dentist |
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| Location | 123 S Pavilion Ave, Riverside, New Jersey |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1790495760
- Provider Enumeration Date: 12/01/2022
- Last Update Date: 12/01/2022
Medical Identifiers
Medical identifiers for Austin Joly Jacob such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1790495760 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 122300000X | Dentist | 22DI02940800 (New Jersey) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Austin Joly Jacob is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Austin Joly Jacob, DMD
123 S Pavilion Ave,
Riverside, NJ 08075-3611
Ph: (856) 393-8510 | Austin Joly Jacob, DMD
123 S Pavilion Ave,
Riverside, NJ 08075-3611
Ph: (856) 393-8510 |
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