Mount Jackson Dental Care, PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

MOUNT JACKSON DENTAL CARE, PLLC

Practice address

5338 Main Street
Mount Jackson, VA 22842

Phone

(540) 477-2901

Fax

(540) 477-2901

NPI assigned

Apr 29, 2024

Last updated

Apr 29, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Michele Deavers

Title

Office Manager

Phone

(540) 477-2901

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1714348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714348800000",
    "number": "1053167213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5338 MAIN STREET",
            "city": "MOUNT JACKSON",
            "state": "VA",
            "postal_code": "22842",
            "telephone_number": "540-477-2901",
            "fax_number": "540-477-2935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5338 MAIN STREET",
            "city": "MOUNT JACKSON",
            "state": "VA",
            "postal_code": "22842",
            "telephone_number": "540-477-2901",
            "fax_number": "540-477-2901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNT JACKSON DENTAL CARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-29",
        "last_updated": "2024-04-29",
        "status": "A",
        "authorized_official_last_name": "DEAVERS",
        "authorized_official_first_name": "MICHELE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "540-477-2901"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly R Harman, D.C.
• Jessica R Jaindl, FNP-C
• Robert E. Keeton, MD
• Carol A Kelley
• Jared Alan Morris
• Mt Jackson Drug Store Inc (Mt Jackson Drug Store)
• Mt. Jackson Family Health
• Kathleen L Muiruri, M.D.
• Venkata Satish Nagineni
• North Mountain Dietetic Services, LLC

• General Practice Dentistry in Mount Jackson, VA
• Providers in Mount Jackson, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.