Active NPI
Emily Ann Jackson, DDS
- Dentist
- San Juan Capistrano, CA
National Provider Identifier
1366883696
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 62206
- Practice address
- 30300 Camino Capistrano
San Juan Capistrano, CA 92675-1304 - Phone
- (949) 240-2030
- Fax
- (949) 429-7627
- NPI assigned
- Jul 15, 2013
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 62206 | CA | Primary |
Addresses
Primary practice location
30300 Camino Capistrano
San Juan Capistrano, CA 92675-1304
Mailing address
PO Box 52754
Irvine, CA 92619-2754
Phone (949) 338-5660
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 |
|---|---|---|---|
| 62206 | CA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1373846400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1373846400000",
"number": "1366883696",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 52754",
"city": "IRVINE",
"state": "CA",
"postal_code": "926192754",
"telephone_number": "949-338-5660"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30300 CAMINO CAPISTRANO",
"city": "SAN JUAN CAPISTRANO",
"state": "CA",
"postal_code": "926751304",
"telephone_number": "949-240-2030",
"fax_number": "949-429-7627"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "EMILY",
"middle_name": "ANN",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-07-15",
"last_updated": "2013-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "62206",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Juan Capistrano, CA
- Ronald Israel
- J. Gegamyan Dental Corp (JG Dental)
- J.F.Shea Therapeutic Riding Center
- J&J Healing Journeys Licensed Professional Clinical Counselor Inc
- Riley Jacko, NP-C
- Karen Sue Jackson, RN BSN
- Lauren Nicole Jackson
- Albrik Patrick Jacobi
- Jacques J Palmer M D Inc
- Jamc&C LLC (Senior Helpers of Dana Point)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.