Active NPI
Julius Deon Jackson, DMD
- Dentist
- Cathedral City, CA
National Provider Identifier
1598028607
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 61383
- Practice address
- 69160 Ramon Rd
Cathedral City, CA 92234-9140 - Phone
- (760) 969-5469
- NPI assigned
- Jun 22, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 61383 | CA | Primary |
Addresses
Primary practice location
69160 Ramon Rd
Cathedral City, CA 92234-9140
Mailing address
9672 Sycamore Canyon Rd
Moreno Valley, CA 92557-1813
Phone (909) 379-8262
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1340323200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1340323200000",
"number": "1598028607",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9672 SYCAMORE CANYON RD",
"city": "MORENO VALLEY",
"state": "CA",
"postal_code": "925571813",
"telephone_number": "909-379-8262"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "69160 RAMON RD",
"city": "CATHEDRAL CITY",
"state": "CA",
"postal_code": "922349140",
"telephone_number": "760-969-5469"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "JULIUS",
"middle_name": "DEON",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-06-22",
"last_updated": "2012-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "61383",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cathedral City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 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.