Michael R. Jackson D.D.S., Inc.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

11498 Issued in TX

Legal business name

MICHAEL R. JACKSON D.D.S., INC.

Practice address

6924 South Fwy
Ft Worth, TX 76134-3800

Phone

(817) 293-7431

Fax

(817) 293-3848

NPI assigned

Apr 3, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Michael Roy Jackson, DDSNPI 1083735369

Title

President Owner

Phone

(817) 293-7431

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Michael Roy Jackson, DDS

  • General Practice Dentistry
  • Ft Worth, TX
  • NPI 1083735369
  NPD (past) Authorized official
• Sushma C Lavu, DDS

  • General Practice Dentistry
  • Fort Worth, TX
  • NPI 1629216551
  NPD (past)

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1437270758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6924 SOUTH FWY",
            "city": "FT WORTH",
            "state": "TX",
            "postal_code": "761343800",
            "telephone_number": "817-293-7431",
            "fax_number": "817-293-3848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6924 SOUTH FWY",
            "city": "FT WORTH",
            "state": "TX",
            "postal_code": "761343800",
            "telephone_number": "817-293-7431",
            "fax_number": "817-293-3848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL R. JACKSON D.D.S., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "ROY",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "817-293-7431",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "11498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael H Boothby, MD PA
• Michael L. Bailey, D.O., P.a.
• Michael N Thompson
• Michael Nazarian Heart & Vascular
• Michael Nazarian MD, Associates
• Sara C Michael, ARNP
• Michaelangelo Dentistry PLLC
• Grant Michalak, PA-C
• Serena Michalsky, MD
• Sally McIntyre Michaud, NNP-BC

• General Practice Dentistry in Ft Worth, TX
• Providers in Ft Worth, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.