Jackson Implants & Periodontics

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

Legal business name

JACKSON IMPLANTS & PERIODONTICS

Practice address

721 17TH Street
Jackson, MI 49203

Phone

(517) 782-3607

Fax

(517) 782-3658

NPI assigned

Apr 22, 2024

Last updated

Apr 22, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kelly Misch, DDS, MS

Title

Owner/Periodontist

Phone

(734) 975-1743

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Salah Al Huwais, DDS

  • Periodontics
  • Jackson, MI
  • NPI 1235262296
  NPD (past)

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

{
    "created_epoch": "1713744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713744000000",
    "number": "1306691381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "721 17TH STREET",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "49203",
            "telephone_number": "517-782-3607",
            "fax_number": "517-782-3658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 17TH STREET",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "49203",
            "telephone_number": "517-782-3607",
            "fax_number": "517-782-3658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON IMPLANTS & PERIODONTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-22",
        "last_updated": "2024-04-22",
        "status": "A",
        "authorized_official_last_name": "MISCH",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "OWNER/PERIODONTIST",
        "authorized_official_telephone_number": "734-975-1743",
        "authorized_official_credential": "DDS, MS"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jackson Healing
• Jackson Healing Clinic LLC
• Jackson Health Network L3C
• Jackson Heart PLLC
• Jackson Home Medical Equipment, Inc. (The Aumack Company)
• Jackson OB-GYN PLC
• Jackson OB/GYN
• Jackson Opco, LLC (Regency at Jackson)
• Jackson Orthopaedic Care & Surgery, P.C.
• Jackson Orthopaedic Care & Surgery, P.C.

• Periodontics in Jackson, MI
• Providers in Jackson, MI by specialty
• Periodontics in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2024; 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.