Alfred Manwuel Jackson, D.D.S., M.S.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

8527 Issued in NC

Practice address

13731 Steele Creek Rd
Charlotte, NC 28273

Phone

(704) 464-0696

Fax

(704) 464-5630

NPI assigned

Mar 5, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• A.M. Jackson DDS Ms PLLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Charlotte, NC
  • NPI 1982337333
  NPD Authorized official
• Alfred M. Jackson DDS,Ms PLLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Charlotte, NC
  • NPI 1922318195
  NPD Authorized official
• Jackson Clover Orthodontics LLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Clover, SC
  • NPI 1154187565
  NPD Authorized official

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

{
    "created_epoch": "1204675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727827200000",
    "number": "1164692224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13731 STEELE CREEK RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28273",
            "telephone_number": "704-464-0696",
            "fax_number": "704-464-5630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13731 STEELE CREEK RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28273",
            "telephone_number": "704-464-0696",
            "fax_number": "704-464-5630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ALFRED",
        "middle_name": "MANWUEL",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-05",
        "last_updated": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NC",
            "license": "8527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jackson Home for Veterans
• Diane O Jackson-Szymczyk, PT
• Yameka Jackson-Williams, OWNER
• Adrienne Jackson
• Alexis Jackson
• Alisa Jackson
• Amber Lynn Jackson, NP
• Amore Nichole Jackson
• Angelica Jackson
• Annie Jackson

• Orthodontics and Dentofacial Orthopedics Dentistry in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 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.