Active NPI
William T K Jackson, DDS
- General Practice Dentistry
- Cockeysville, MD
National Provider Identifier
1285798512
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 12042
- Practice address
- 10151 York Road
Suite 110
Cockeysville, MD 21030-3314 - Phone
- (410) 667-4222
- Fax
- (410) 667-4494
- NPI assigned
- Dec 21, 2006
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 12042 | MD | Primary |
Addresses
Primary practice location
10151 York Road
Suite 110
Cockeysville, MD 21030-3314
Mailing address
2 Clarion CT
Hunt Valley, MD 21030-2653
Phone (410) 256-7300
Other names 1
- Kent Jackson
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12042 | MD | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Edward Leventhal Ddspa | Past | Accepting new patients |
Organizations & group practices 1
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 Laboratory
- Baltimore, MD
- NPI 1821491572
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166659200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611705600000",
"number": "1285798512",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 CLARION CT",
"city": "HUNT VALLEY",
"state": "MD",
"postal_code": "210302653",
"telephone_number": "410-256-7300",
"fax_number": "410-529-0951"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10151 YORK ROAD",
"address_2": "SUITE 110",
"city": "COCKEYSVILLE",
"state": "MD",
"postal_code": "210303314",
"telephone_number": "410-667-4222",
"fax_number": "410-667-4494"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "WILLIAM",
"middle_name": "T K",
"name_prefix": "Mr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-21",
"last_updated": "2021-01-27",
"certification_date": "2021-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MD",
"license": "12042",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KENT",
"last_name": "JACKSON",
"credential": "D.D.S.",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Cockeysville, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.