Sanjie Jackson, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

DN18059 Issued in FL

Practice address

1044 Belcher Road
Dunedin, FL 34698

Phone

(727) 738-8845

Fax

(727) 738-1466

NPI assigned

Jul 10, 2007

Sex

Female

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

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Dental Office of Dunedin, Inc

  • General Practice Dentistry
  • Dunedin, FL
  • NPI 1144796293
  NPD (past)
• Dental Office of Tampa LLC

  • General Practice Dentistry
  • Tampa, FL
  • NPI 1770309726
  NPD (past)

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

{
    "created_epoch": "1184025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386028800000",
    "number": "1184822397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1044 BELCHER ROAD",
            "city": "DUNEDIN",
            "state": "FL",
            "postal_code": "34698",
            "telephone_number": "727-738-8845",
            "fax_number": "727-738-1466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1044 BELCHER ROAD",
            "city": "DUNEDIN",
            "state": "FL",
            "postal_code": "34698",
            "telephone_number": "727-738-8845",
            "fax_number": "727-738-1466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "SANJIE",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-10",
        "last_updated": "2013-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN18059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Invicta Park Place LLC
• Invision Eyecare Inc.
• Katherine Isaza, PSY.D.
• Jack E Beebe MD PA
• Jack N Rothman MD
• James a. Diienno, D.C., P.a.
• James Phillip Long DPM PA
• James R. Kinney Jr., Psy.D., P.L.L.C.
• Jamie Goodman D.C, P.a.
• Katherine Javier, M.S. CCC-SLP

• Dentist in Dunedin, FL
• Providers in Dunedin, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2013; 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.

Verify at the official NPI Registry.