Austin Joly Jacob, DMD

Dentist · Riverside, NJ

Individual Active NPI

NPI number 1790495760

Practice location

123 S Pavilion Ave
Riverside, NJ 08075-3611
Phone
(856) 393-8510

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NPI record

NPI
1790495760
Entity type
Individual (Type 1)
Enumeration date
December 1, 2022
Last updated
February 18, 2025
Certified
February 18, 2025
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Dentist Primary 122300000X DS043994 PA
Dentist 122300000X 22DI02940800 NJ

About Dr. Jacob

Austin Joly Jacob, DMD is a healthcare provider registered in the NPI registry with the primary taxonomy Dentist (code 122300000X). The practice location is 123 S Pavilion Ave, Riverside, NJ 08075-3611. The NPI number 1790495760 was assigned on December 1, 2022 and the record was last updated on February 18, 2025.

Dr. Jacob lists 2 licenses in the registry: #DS043994 (PA) for Dentist; #22DI02940800 (NJ) for Dentist. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Austin Joly Jacob, DMD?

The NPI number is 1790495760.

What is the phone number of Dr. Jacob?

The phone number listed for the practice location is (856) 393-8510.

Where is Dr. Jacob located?

123 S Pavilion Ave, Riverside, NJ 08075-3611.

What is the taxonomy code for Dr. Jacob?

The primary taxonomy code is 122300000X – Dentist; 1 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.