Brandi R. Jackson DDS, Ms, PLLC

Primary specialty

DentistTaxonomy code 122300000X

License

8224 Issued in NC

Legal business name

BRANDI R. JACKSON DDS, MS, PLLC

Doing business as

Northeast Pediatric Dentistry

Practice address

11223 Davinci Dr
Davidson, NC 28036-7799

Phone

(704) 895-6445

Fax

(704) 895-6496

NPI assigned

Aug 31, 2011

Last updated

Aug 31, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Brandi R Jackson, DDS, MSNPI 1912186321

Title

Owner/Dentist

Phone

(704) 895-6445

Specialties & licenses 1

Addresses

Other names 1

• Northeast Pediatric Dentistry Doing business as

Practitioners 1

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.

• Brandi Rochelle Jackson, DDS

  • Pediatric Dentistry
  • Davidson, NC
  • NPI 1912186321
  NPD (past) Authorized official

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

{
    "created_epoch": "1314748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314748800000",
    "number": "1881975191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11223 DAVINCI DR",
            "city": "DAVIDSON",
            "state": "NC",
            "postal_code": "280367799",
            "telephone_number": "704-895-6445",
            "fax_number": "704-895-6496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11223 DAVINCI DR",
            "city": "DAVIDSON",
            "state": "NC",
            "postal_code": "280367799",
            "telephone_number": "704-895-6445",
            "fax_number": "704-895-6496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRANDI R. JACKSON DDS, MS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-31",
        "last_updated": "2011-08-31",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "BRANDI",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "704-895-6445",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NC",
            "license": "8224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northeast Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kaylee A Bodner, LCSW-A, LCAS-A
• Samantha Boone, RN
• Amanda Jones Bossert, CRC, LCMHCA
• Lynneice Lasinda Bowen, MD
• BPM Counseling, PLLC
• Taylor Brant, MS, LCMHC-A, CRC
• Katherine Bray
• Linda Bresnahan, MD
• Brian T. Seese, D.M.D., P.a.
• Allison Caitlin Broome, FNP-C

• Dentist in Davidson, NC
• Providers in Davidson, NC by specialty
• Dentist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2011; 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.