Dennis M Jackson MD Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

70142 Issued in NM

Legal business name

DENNIS M JACKSON MD INC

Practice address

460 Saint Michaels Dr
#1005
Santa Fe, NM 87505-7619

Phone

(505) 490-9738

NPI assigned

Apr 20, 2009

Organization subpart

No

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

Authorized official

Name

Dennis M Jackson, MD

Title

President

Phone

(505) 490-9738

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1240185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240185600000",
    "number": "1194969220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5112 HOLLYWOOD BLVD",
            "address_2": "#111 PMB 106",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900276126",
            "telephone_number": "505-490-9738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 SAINT MICHAELS DR",
            "address_2": "#1005",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875057619",
            "telephone_number": "505-490-9738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENNIS M JACKSON MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-20",
        "last_updated": "2009-04-20",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "505-490-9738",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "70142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elaine Delvalle, LISW
• Haley Nichole Demaree, LPCC
• Brianna Denenny
• David P Dennedy-Frank, PH.D.
• Gene Dennehy, LPCC, LADAC
• Ruth A Dennis, LPCC, ATR-BC
• Dental Arts of Santa Fe, PC
• Dental del Sol, LLC
• Dental Fitness, PC
• Dental Hygiene Care of Santa Fe Inc

• Family Medicine Physician in Santa Fe, NM
• Providers in Santa Fe, NM by specialty
• Family Medicine Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2009; 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.