Dr Brandon Jackson Pediatric Dental PLLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

DR BRANDON JACKSON PEDIATRIC DENTAL PLLC

Doing business as

Quality Care, Pediatric Dental Specialists

Practice address

821 Clove Rd
Staten Island, NY 10310-2839

Phone

(718) 448-0976

NPI assigned

Dec 9, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Brandon Joshua Jackson, DDSNPI 1861753949

Title

Owner

Phone

(917) 626-3507

Specialties & licenses 1

Addresses

Other names 1

• Quality Care, Pediatric Dental Specialists Doing business as

Locations

Practitioners 1

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

• Brandon Joshua Jackson, D.D.S

  • Pediatric Dentistry
  • Staten Island, NY
  • NPI 1861753949
  NPD Authorized official

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

{
    "created_epoch": "1670544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670544000000",
    "number": "1629789722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 VIRGINIA AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103051748",
            "telephone_number": "917-626-3507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "821 CLOVE RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103102839",
            "telephone_number": "718-448-0976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR BRANDON JACKSON PEDIATRIC DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-09",
        "last_updated": "2022-12-09",
        "certification_date": "2022-12-08",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_middle_name": "JOSHUA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-626-3507",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Quality Care, Pediatric Dental Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Colleen Downes, L.C.S.W.
• Maddie Downes, OTR/L
• Diane C Doyle, RN
• Inna Doyle, M.S. ED.
• DP Radiology Imaging PC
• Dr Edmund KP Ling-Chung Physician
• Dr James G Reilly DO PC
• Dr Joseph D Cuomo Podiatry PC
• Dr Kristie Lazzara, DC
• Dr M Yaghi Dental PLLC

• Pediatric Dentistry in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Pediatric Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2022; 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.