Leia Nicole Jackson, D.D.S

Primary specialty

DentistTaxonomy code 122300000X

License

29290 Issued in TX

Practice address

8707 Spring Cypress Rd
Suite a
Spring, TX 77379-3330

Phone

(281) 320-1150

NPI assigned

Jul 10, 2013

Sex

Female

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

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

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

• Spring Cypress Modern Dentistry, PC

  dba Spring Cypress Modern Dentistry and Orthodontics

  • General Practice Dentistry
  • Spring, TX
  • NPI 1235498411
  NPD (past)

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

{
    "created_epoch": "1373414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373414400000",
    "number": "1760823496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11245 WEST RD",
            "address_2": "APT #138A",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770654828",
            "telephone_number": "605-484-9836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8707 SPRING CYPRESS RD",
            "address_2": "SUITE A",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773793330",
            "telephone_number": "281-320-1150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "LEIA",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-10",
        "last_updated": "2013-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "29290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaitlin Denise Jackson
• Kaneisha Jackson
• Kelly Teague Jackson, APRN, FNP
• Laurie J Jackson, CRNA
• Lea Ann Jackson, F.NP
• Lisa Jackson, PCA
• Lychelle Kristine Jackson, FNP-C
• Norma Jackson
• Rita Jackson, P.T.
• Tatiana Jackson

• Dentist in Spring, TX
• Providers in Spring, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.