NPIMap

Organization Active NPI

James Andrew Jackson, DDS, PLLC

  • Dentist
  • Olive Branch, MS
National Provider Identifier
1417339185
Registry record updated Jun 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
3811-15 Issued in MS
Legal business name
JAMES ANDREW JACKSON, DDS, PLLC
Practice address
9035 E Sandidge Rd Ste 100
Olive Branch, MS 38654-3563
Phone
(662) 895-7338
Fax
(662) 895-7040
NPI assigned
Jun 18, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2015

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

Authorized official

Name
Dr. James Andrew Jackson, DDS
Title
O
Phone
(662) 895-7338

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 3811-15 MS Primary

Addresses

Primary practice location

9035 E Sandidge Rd Ste 100
Olive Branch, MS 38654-3563

Mailing address

9035 East Sandidge Rd, Suite 100
Olive Branch, MS 38654
Phone (662) 895-7338

Other names 1

  • Jackson Family Dentistry Other name

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1434585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434585600000",
    "number": "1417339185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9035 EAST SANDIDGE RD, SUITE 100",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "38654",
            "telephone_number": "662-895-7338",
            "fax_number": "662-895-7040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9035 E SANDIDGE RD STE 100",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386543563",
            "telephone_number": "662-895-7338",
            "fax_number": "662-895-7040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMES ANDREW JACKSON, DDS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-18",
        "last_updated": "2015-06-18",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "O",
        "authorized_official_telephone_number": "662-895-7338",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MS",
            "license": "3811-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jackson Family Dentistry",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Olive Branch, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2015; 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.