Jackson and Lee Dental Corporation

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

JACKSON AND LEE DENTAL CORPORATION

Doing business as

PLAZA DENTAL GROUP

Practice address

40484 Murrieta Hot Springs Rd
Ste. 102
Murrieta, CA 92563-6400

Phone

(951) 461-4306

Fax

(951) 461-4735

NPI assigned

Dec 20, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Jonathan Jackson, DDS

Title

Owner DDS

Phone

(951) 461-4306

Specialties & licenses 1

Addresses

Other names 1

• PLAZA DENTAL GROUP Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Dominique Solis Mancilla

  • General Practice Dentistry
  • Murrieta, CA
  • NPI 1518844794
  NPD (past)

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652227200000",
    "number": "1881758241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 920050",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753920050",
            "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": "40484 MURRIETA HOT SPRINGS RD",
            "address_2": "STE. 102",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925636400",
            "telephone_number": "951-461-4306",
            "fax_number": "951-461-4735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON AND LEE DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-20",
        "last_updated": "2022-05-11",
        "certification_date": "2022-05-11",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "OWNER DDS",
        "authorized_official_telephone_number": "951-461-4306",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PLAZA DENTAL GROUP",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PLAZA DENTAL GROUP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Gordon Iwasaki, PA
• J Carter Corporation
• J Keyes Eto Inc
• Jack J Druet, MD, Inc.
• Danielle Jack
• Antoinette S Jackson-Sekunda, NP
• Amari Jackson
• Lester Jackson
• Olga R Jackson, FNP-BC, PMHNP-BC
• Renae Jackson

• General Practice Dentistry in Murrieta, CA
• Providers in Murrieta, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2022; 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.