Arlita D Jackson, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN11004 Issued in GA

Practice address

1790 Mulkey Rd
BLDG 4
Austell, GA 30106-1103

Phone

(770) 739-4400

Fax

(770) 739-9077

NPI assigned

Mar 5, 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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Twiilight Dental Care,LLC

  • Dentist
  • Columbus, GA
  • NPI 1487335048
  NPD Authorized official
• Twiilight Dental Care,LLC

  • Dental Clinic/Center
  • Columbus, GA
  • NPI 1275313538
  NPD

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337731200000",
    "number": "1194854901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1790 MULKEY RD",
            "address_2": "STE4",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301061122",
            "telephone_number": "770-739-4400",
            "fax_number": "770-739-9077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1790 MULKEY RD",
            "address_2": "BLDG 4",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301061103",
            "telephone_number": "770-739-4400",
            "fax_number": "770-739-9077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ARLITA",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-05",
        "last_updated": "2012-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN11004",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00480213B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julian T Isakow, M.D.
• Isd Renal Inc
• Frank T Italiano, MD
• Karen Belinda Ivey, FNP-C
• Josephine I Iyabor
• Malia R. Jackson, OTD, OTR/L
• Manekia K Jackson
• Lakanya Dawnielle Jacobs
• Stephanie Ann Jaipaul, DMD
• Sri Rasmita Jalla

• General Practice Dentistry in Austell, GA
• Providers in Austell, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2012; 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.