Jackqueline McLean DDS LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

JACKQUELINE MCLEAN DDS LLC

Practice address

3738 Park Ave
Bridgeport, CT 06604-1020

Phone

(203) 549-9099

Fax

(203) 549-9820

NPI assigned

Jan 24, 2019

Organization subpart

Yes

Parent organization

JACKQUELINE MCLEAN DDS LLCAs reported in NPPES

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

Authorized official

Name

Dr. Jackqueline McLean, DDS

Title

Owner

Phone

(203) 549-9099

Specialties & licenses 1

Addresses

Other names 1

• Mcleansmiles Doing business as

Part of

Jackqueline McLean DDS LLC

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

{
    "created_epoch": "1548288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548288000000",
    "number": "1497219489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3738 PARK AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066041020",
            "telephone_number": "203-549-9099",
            "fax_number": "203-549-9820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3738 PARK AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066041020",
            "telephone_number": "203-549-9099",
            "fax_number": "203-549-9820"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "23 Hoyt St",
            "address_purpose": "LOCATION",
            "city": "Stamford",
            "state": "CT",
            "postal_code": "069055604",
            "country_code": "US",
            "telephone_number": "203-327-6717",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JACKQUELINE MCLEAN DDS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JACKQUELINE MCLEAN DDS LLC",
        "enumeration_date": "2019-01-24",
        "last_updated": "2019-01-24",
        "status": "A",
        "authorized_official_last_name": "MCLEAN",
        "authorized_official_first_name": "JACKQUELINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-549-9099",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mcleansmiles",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Irene Gintare Ivaska, LCSW
• Clifford Ives
• Ivey Lead Nursing Services, LLC
• Iya Therapy and Wellness PLLC
• Sumedh Krishna Iyengar, MD
• Juliet Alexandra Jackson, MD
• Marcus Kirk Jackson, LCSW
• Natacha Jackson
• Samyiah Destiny Jackson
• Tatiana Y Jackson

• General Practice Dentistry in Bridgeport, CT
• Providers in Bridgeport, CT by specialty
• General Practice Dentistry in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2019; 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.