Henry Lee Jackson Jr., DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

10922 Issued in NC

Practice address

334 E Hanes Mill Rd
Winston Salem, NC 27105-9135

Phone

(336) 450-2077

NPI assigned

Feb 7, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Alles & Associates North Carolina

  • Dentist
  • Winston Salem, NC
  • NPI 1306597695
  NPD (past)
• Alterman & Dhillon Piedmont, PPLC

  • Dentist
  • Winston Salem, NC
  • NPI 1033600382
  NPD (past)

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

{
    "created_epoch": "1486425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540252800000",
    "number": "1699213959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 CROWNE CHASE DR APT 16",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271043582",
            "telephone_number": "631-671-1137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "334 E HANES MILL RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271059135",
            "telephone_number": "336-450-2077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "HENRY",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-02-07",
        "last_updated": "2018-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "10922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Shavon Jackson, MD
• Campbell Gray Jackson
• David Stone Jackson Jr., MD
• Gia Annalise Jackson
• Hayn Arrington Jackson, MD
• Jennifer Jackson
• Jennifer Marie Jackson, MD
• Jimmy Demario Jackson, OTRL
• Kasey Jackson
• Kerrington Jackson

• General Practice Dentistry in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2018; 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.