NPIMap

Organization Active NPI

Brian E Jackson DDS LLC

  • Durable Medical Equipment & Medical Supplies
  • Willoughby Hills, OH
National Provider Identifier
1306400353
Registry record updated Apr 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
BRIAN E JACKSON DDS LLC
Practice address
2775 Bishop Rd Ste C
Willoughby Hills, OH 44092-2683
Phone
(440) 944-7775
Fax
(440) 944-7887
NPI assigned
Apr 25, 2019
Organization subpart
Yes
Parent organization
BRIAN E JACKSON DDS LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 25, 2019

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

Authorized official

Name
Dr. Brian Edward Jackson, DDSNPI 1689665408
Title
Owner
Phone
(440) 944-7775

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

2775 Bishop Rd Ste C
Willoughby Hills, OH 44092-2683

Mailing address

2775 Bishop Rd Ste C
Willoughby Hills, OH 44092-2683
Phone (440) 944-7775

National Provider Directory

National Provider Directory
Part of
Brian E Jackson DDS LLC

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1556150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556150400000",
    "number": "1306400353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2775 BISHOP RD STE C",
            "city": "WILLOUGHBY HILLS",
            "state": "OH",
            "postal_code": "440922683",
            "telephone_number": "440-944-7775",
            "fax_number": "440-944-7887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2775 BISHOP RD STE C",
            "city": "WILLOUGHBY HILLS",
            "state": "OH",
            "postal_code": "440922683",
            "telephone_number": "440-944-7775",
            "fax_number": "440-944-7887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIAN E JACKSON DDS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BRIAN E JACKSON DDS LLC",
        "enumeration_date": "2019-04-25",
        "last_updated": "2019-04-25",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "440-944-7775",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willoughby Hills, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2019; 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.