Austin Jackson, DMD

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

1611 NW 12TH Ave
Acc East, Room 234
Miami, FL 33136-1096

Phone

(305) 585-5326

NPI assigned

Feb 19, 2024

Last updated

Feb 19, 2024By the provider in NPPES

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

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

{
    "created_epoch": "1708300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708300800000",
    "number": "1821853938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 NW 12TH AVE RM 234",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361096",
            "telephone_number": "305-585-5326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 NW 12TH AVE",
            "address_2": "ACC EAST, ROOM 234",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361096",
            "telephone_number": "305-585-5326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "AUSTIN",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-02-19",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jackson Plaza Inc
• Jackson Preferred Care LLC
• Jackson Rehab Operations LLC.
• Jackson South Community Hospital
• Andrea Jasmine Jackson
• Avis Shantrell Jackson
• Brenda Ann Jackson
• Georgiana Jackson
• James John Jackson, MS,OTR,CHT
• Jeffrey Lamar Jackson II, DC

• Student in an Organized Health Care Education/Training Program in Miami, FL
• Providers in Miami, FL by specialty
• Student in an Organized Health Care Education/Training Program in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2024; 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.