Marlon B. Jackson DDS,PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9878 Issued in GA

Legal business name

MARLON B. JACKSON DDS,PC

Practice address

210 Auburn Ave NE
Suite 1
Atlanta, GA 30303-2610

Phone

(404) 681-3834

Fax

(404) 681-9108

NPI assigned

Sep 17, 2008

Last updated

Sep 17, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Marlon Bradford Jackson, D.D.S., P.C.

Title

Owner

Phone

(404) 681-3834

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1221609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221609600000",
    "number": "1598914343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 AUBURN AVE NE",
            "address_2": "SUITE 1",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303032610",
            "telephone_number": "404-681-3834",
            "fax_number": "404-681-9108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 AUBURN AVE NE",
            "address_2": "SUITE 1",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303032610",
            "telephone_number": "404-681-3834",
            "fax_number": "404-681-9108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARLON B. JACKSON DDS,PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-17",
        "last_updated": "2008-09-17",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "MARLON",
        "authorized_official_middle_name": "BRADFORD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-681-3834",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S., P.C."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "9878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Atlanta, GA
• Providers in Atlanta, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2008; 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.