Christa L Jackson Dental Hygienist, Inc.

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

Legal business name

CHRISTA L JACKSON DENTAL HYGIENIST, INC.

Practice address

4508 Saint Clair Ave
Studio City, CA 91604-1209

Phone

(818) 269-8898

Fax

(818) 506-2595

NPI assigned

Jun 10, 2021

Organization subpart

No

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

Authorized official

Name

Mrs. Christa Lynn Jackson, RDHAPNPI 1285942243

Title

President

Phone

(818) 269-8898

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.

• Christa Lynn Jackson, R.D.H.A.P.

  • Dental Hygienist
  • Studio City, CA
  • NPI 1285942243
  NPD Authorized official

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

{
    "created_epoch": "1623283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630022400000",
    "number": "1447827167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4508 SAINT CLAIR AVE",
            "city": "STUDIO CITY",
            "state": "CA",
            "postal_code": "916041209",
            "telephone_number": "818-269-8898",
            "fax_number": "818-506-2595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4508 SAINT CLAIR AVE",
            "city": "STUDIO CITY",
            "state": "CA",
            "postal_code": "916041209",
            "telephone_number": "818-269-8898",
            "fax_number": "818-506-2595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTA L JACKSON DENTAL HYGIENIST, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-10",
        "last_updated": "2021-08-27",
        "certification_date": "2021-08-26",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "CHRISTA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-269-8898",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RDHAP"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dental Hygienist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "128592243",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• City HHA Inc
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• Dental Hygienist in Studio City, CA
• Providers in Studio City, CA by specialty
• Dental Hygienist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2021; 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.