NPIMap

Organization Active NPI

Jackson and Moore Professional Corporation

Doing business as Hub Plaza Dental Group

  • General Practice Dentistry
  • San Bernardino, CA
National Provider Identifier
1841396637
Registry record updated May 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
JACKSON AND MOORE PROFESSIONAL CORPORATION
Doing business as
Hub Plaza Dental Group
Practice address
1047 Harriman PL
Ste. B
San Bernardino, CA 92408-4203
Phone
(909) 796-6700
Fax
(909) 796-6779
NPI assigned
Sep 16, 2006
Last updated
May 29, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 29, 2009

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

Authorized official

Name
Dr. Tanisha A Jackson, DDSNPI 1629183777
Title
Owner DDS
Phone
(909) 796-6700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X Primary

Addresses

Primary practice location

1047 Harriman PL
Ste. B
San Bernardino, CA 92408-4203

Mailing address

2860 Michelle
2ND Floor
Irvine, CA 92606-1009
Phone (714) 508-3600

Other names 1

  • HUB PLAZA DENTAL GROUP Doing business as

National Provider Directory

National Provider Directory

Locations

1047 Harriman Pl
#B
San Bernardino, CA 92408
Phone (909) 435-0667

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243555200000",
    "number": "1841396637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2860 MICHELLE",
            "address_2": "2ND FLOOR",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926061009",
            "telephone_number": "714-508-3600",
            "fax_number": "714-368-2092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1047 HARRIMAN PL",
            "address_2": "STE. B",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924084203",
            "telephone_number": "909-796-6700",
            "fax_number": "909-796-6779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON AND MOORE PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-16",
        "last_updated": "2009-05-29",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "TANISHA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER DDS",
        "authorized_official_telephone_number": "909-796-6700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HUB PLAZA DENTAL GROUP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Bernardino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2009; 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.