A.M. Jackson DDS Ms PLLC

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

Legal business name

A.M. JACKSON DDS MS PLLC

Practice address

13731 Steele Creek Rd Ste B
Charlotte, NC 28273-6841

Phone

(352) 256-8164

NPI assigned

Jul 5, 2022

Last updated

Jul 5, 2022By 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. Alfred M. JacksonNPI 1164692224

Title

Owner

Phone

(352) 256-8164

Specialties & licenses 2

Addresses

Electronic endpoints 1

Locations

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.

• Alfred Manwuel Jackson, D.D.S., M.S.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Charlotte, NC
  • NPI 1164692224
  NPD Authorized official

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

{
    "created_epoch": "1656979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656979200000",
    "number": "1982337333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13731 STEELE CREEK RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282736841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13731 STEELE CREEK RD STE B",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282736841",
            "telephone_number": "352-256-8164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A.M. JACKSON DDS MS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-05",
        "last_updated": "2022-07-05",
        "certification_date": "2022-07-05",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "ALFRED",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "352-256-8164",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "creeksidesmiles1@gmail.com",
            "affiliation": "N",
            "address_1": "13731 Steele Creek Rd Ste B",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282736841",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Orthodontics and Dentofacial Orthopedics Dentistry in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 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.