NPIMap

Organization Active NPI

Jackman Family Dentistry

  • Dentist
  • Vacaville, CA
National Provider Identifier
1083630248
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
33203 Issued in CA
Legal business name
JACKMAN FAMILY DENTISTRY
Practice address
501B Nut Tree CT
Vacaville, CA 95687
Phone
(707) 451-2982
Fax
(707) 451-0391
NPI assigned
Jul 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Martin Bairstow Jackman, DDSNPI 1558370056
Title
Owner
Phone
(707) 451-2982

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 33203 CA Primary

Addresses

Primary practice location

501B Nut Tree CT
Vacaville, CA 95687

Mailing address

501B Nut Tree CT
Vacaville, CA 95687
Phone (707) 451-2982

National Provider Directory

National Provider Directory

Locations

501 Nut Tree Ct
Ste B
Vacaville, CA 95687
Phone (707) 451-2982

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1083630248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501B NUT TREE CT",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "95687",
            "telephone_number": "707-451-2982",
            "fax_number": "707-451-0391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501B NUT TREE CT",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "95687",
            "telephone_number": "707-451-2982",
            "fax_number": "707-451-0391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKMAN FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JACKMAN",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "BAIRSTOW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "707-451-2982",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "33203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vacaville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.