Active NPI
Sioney L. Jackson, DENTIST
- Dentist
- Fresno, CA
National Provider Identifier
1780985119
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 26076
- Practice address
- 7433 N. First St.
Suite #101
Fresno, CA 93720 - Phone
- (559) 447-3003
- Fax
- (559) 432-7824
- NPI assigned
- Nov 17, 2010
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 26076 | CA | Primary |
Addresses
Primary practice location
7433 N. First St.
Suite #101
Fresno, CA 93720
Mailing address
7433 N. First St.
Suite #101
Fresno, CA 93720
Phone (559) 447-3003
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1289952000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1289952000000",
"number": "1780985119",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7433 N. FIRST ST.",
"address_2": "SUITE #101",
"city": "FRESNO",
"state": "CA",
"postal_code": "93720",
"telephone_number": "559-447-3003",
"fax_number": "559-432-7824"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7433 N. FIRST ST.",
"address_2": "SUITE #101",
"city": "FRESNO",
"state": "CA",
"postal_code": "93720",
"telephone_number": "559-447-3003",
"fax_number": "559-432-7824"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "SIONEY",
"middle_name": "L.",
"name_prefix": "Dr.",
"credential": "DENTIST",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-11-17",
"last_updated": "2010-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "26076",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fresno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.