Hannah Jordan Jackson, DMD

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

12013180A Issued in IN

Practice address

4317 Charlestown Rd
New Albany, IN 47150-8506

Phone

(812) 258-9626

NPI assigned

Jul 12, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Jackson Dental Health Specialists, PLLC

  • Pediatric Dentistry
  • Louisville, KY
  • NPI 1770423287
  NPD Authorized official
• Schulten Pediatric Dentistry - New Albany LLC

  • Pediatric Dentistry
  • New Albany, IN
  • NPI 1285128512
  NPD

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

{
    "created_epoch": "1562889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688688000000",
    "number": "1396397048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4317 CHARLESTOWN RD",
            "city": "NEW ALBANY",
            "state": "IN",
            "postal_code": "471508506",
            "telephone_number": "812-258-9626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4317 CHARLESTOWN RD",
            "city": "NEW ALBANY",
            "state": "IN",
            "postal_code": "471508506",
            "telephone_number": "812-258-9626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "HANNAH",
        "middle_name": "JORDAN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-12",
        "last_updated": "2023-07-07",
        "certification_date": "2023-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "KY",
            "license": "10885",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "IN",
            "license": "12013180A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• J Craig Cook DDS, PC
• J Michael Williams DMD LLC
• Abdul Jabbar, MD
• Derrick Jack, LCSW
• Kimberly Latrice Jackson-Grundy, PHARMD
• Jessica Jackson, DPM
• Nicole Jackson
• Regina Jackson
• Jacque Deshay Young, PLLC
• Cara Harris James, D.M.D

• Pediatric Dentistry in New Albany, IN
• Providers in New Albany, IN by specialty
• Pediatric Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.