Dr Richard K Jackson PA

Primary specialty

DentistTaxonomy code 122300000X

License

DN12332 Issued in FL

Legal business name

DR RICHARD K JACKSON PA

Practice address

326 W Boynton Beach Blvd
Boynton Beach, FL 33435-4025

Phone

(561) 737-6445

Fax

(561) 737-1524

NPI assigned

Jan 19, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Richard K Jackson, DDSNPI 1629046339

Title

Dentist

Phone

(561) 737-6445

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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

• Richard K Jackson, DDS

  • General Practice Dentistry
  • West Palm Beach, FL
  • NPI 1629046339
  NPD (past) Authorized official

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

{
    "created_epoch": "1326931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326931200000",
    "number": "1407127640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "326 W BOYNTON BEACH BLVD",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334354025",
            "telephone_number": "561-737-6445",
            "fax_number": "561-737-1524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "326 W BOYNTON BEACH BLVD",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334354025",
            "telephone_number": "561-737-6445",
            "fax_number": "561-737-1524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR RICHARD K JACKSON PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-19",
        "last_updated": "2012-01-19",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "561-737-6445",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN12332",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "073772100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Boynton Beach, FL
• Providers in Boynton Beach, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2012; 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.