George F. Jackson Jr.
Individual provider Active NPI Dentist · Lansing, KS
NPI 1295987568 · NPPES record last updated Oct 17, 2008
Key facts
- NPI
- 1295987568
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 6594 (KS)
- Practice address
- 1000 N Main St Ste 5
Lansing, KS 66043-1315 - Phone
- (913) 727-5522
- NPI assigned
- Oct 17, 2008
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6594 | KS | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 6594 | KS | Yes |
Addresses
Primary practice location
1000 N Main St Ste 5
Lansing, KS 66043-1315
Mailing address
1000 N Main St Ste 5
Lansing, KS 66043-1315
Other providers in Lansing, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 17, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.