Melissa Jackson, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6850 Issued in OK

Practice address

2539 S Columbia PL
Tulsa, OK 74114-3232

Phone

(504) 638-6479

NPI assigned

Mar 4, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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 and National Provider Directory roles.

• Mark E Whitney DDS, PC

  • Dental Clinic/Center
  • Tulsa, OK
  • NPI 1902073505
  NPD (past)

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

{
    "created_epoch": "1425427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1881086577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2539 S COLUMBIA PL",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741143232",
            "telephone_number": "504-638-6479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2539 S COLUMBIA PL",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741143232",
            "telephone_number": "504-638-6479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "MELISSA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-04",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "OK",
            "license": "6850",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OKLAHOMA DENTAL BOARD",
            "identifier": "6850",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Letitia Jackson, MD
• Mackenzie Jackson
• Mandi Jackson
• Maranda Faye Jackson
• Marnie Monika Jackson
• Mikia Jackson
• Paul Jackson
• Raynisha Jackson
• Regina Jackson
• Robert Lawrence Jackson Jr.

• General Practice Dentistry in Tulsa, OK
• Providers in Tulsa, OK by specialty
• General Practice Dentistry in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.