Active NPI
Tate H Jackson, DDS, MS
- General Practice Dentistry
- Chapel Hill, NC
National Provider Identifier
1730409889
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 8946
- Practice address
- 273 Brauer Hall
Campus Box 7450
Chapel Hill, NC 27599-7450 - Phone
- (919) 537-3775
- NPI assigned
- Jun 10, 2010
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 8946 | NC | Primary |
Addresses
Primary practice location
273 Brauer Hall
Campus Box 7450
Chapel Hill, NC 27599-7450
Mailing address
273 Brauer Hall
Campus Box 7450
Chapel Hill, NC 27599-7450
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8946 | NC | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1276128000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1455494400000",
"number": "1730409889",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "273 BRAUER HALL",
"address_2": "CAMPUS BOX 7450",
"city": "CHAPEL HILL",
"state": "NC",
"postal_code": "275997450"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "273 BRAUER HALL",
"address_2": "CAMPUS BOX 7450",
"city": "CHAPEL HILL",
"state": "NC",
"postal_code": "275997450",
"telephone_number": "919-537-3775"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "TATE",
"middle_name": "H",
"name_prefix": "Dr.",
"credential": "DDS, MS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-06-10",
"last_updated": "2016-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NC",
"license": "8946",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chapel Hill, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.