Active NPI
Donald Jackman, D.D.S.
- Dentist
- Robstown, TX
National Provider Identifier
1124023395
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 16198
- Practice address
- 109 E Avenue J
Robstown, TX 78380-2347 - Phone
- (361) 387-1531
- NPI assigned
- Jun 15, 2005
- Last updated
- Jul 9, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 16198 | TX | Primary |
Addresses
Primary practice location
109 E Avenue J
Robstown, TX 78380-2347
Mailing address
8029 Etienne Dr
Corpus Christi, TX 78414-6027
Phone (361) 299-5777
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240816003951 | TX | Practitioner - Dentist | 9234556051 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118793600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1124023395",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8029 ETIENNE DR",
"city": "CORPUS CHRISTI",
"state": "TX",
"postal_code": "784146027",
"telephone_number": "361-299-5777"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "109 E AVENUE J",
"city": "ROBSTOWN",
"state": "TX",
"postal_code": "783802347",
"telephone_number": "361-387-1531"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKMAN",
"first_name": "DONALD",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-15",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "16198",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Robstown, TX
- Ronald Holdorf, PA-C
- Jennifer Cecile Hole
- I&a Dental PLLC (Robstown Smiles)
- Integrityrx, LLC
- Isd Renal Inc (Riverside Renal Center)
- Jkpjj Healthcare Systems, Inc. (Caridad Adult Day Care Centers)
- Joe E. Saenz Jr (Saenz Medical Equipment and Supplies)
- Juan Sygal, M.D., P.a.
- Alexis King, PHARMD
- La Mansion Adult Day Care Center, Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.