MR. SEAN JACKSON (NPI# 1114368917) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114368917 |
| Entity Type | Individual |
| Full Name | MR. SEAN JACKSON |
| Credential | RDH |
| Practice Address |
111 W 7 Mile Rd Detroit MI 48203-1968 |
| Practice Telephone | 3133692600 |
| Practice Fax Number | 3133692477 |
| Mailing Telephone | 3133692600 |
| Mailing Fax Number | 3133692477 |
| Enumeration Date | 2013-07-10 |
| Last Update Date | 2013-07-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 124Q00000X | Dental Hygienist | 2902014962 | MI | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720685050 | Sean Jackson | Nurse Practitioner | 217 Tradewinds Cir, Alabaster, AL 35007-3019 | 2020-10-09 |
| 1861059784 | Sean Jackson | Physician Assistant | 16851 Tava Ln, Riverside, CA 92504-5809 | 2019-05-27 |
| 1558989541 | Sean Jackson | Behavioral Analyst | 24124 Cinco Village Center Blvd Ste 200, Katy, TX 77494-8389 | 2020-07-07 |
| 1740756899 | Sean Jackson | Community Health Worker | 7455 Arroyo Crossing Pkwy Ste 220, Las Vegas, NV 89113-4088 | 2018-10-16 |
| 1518317353 | Sean Jackson | Counselor | 770 Woodlane Rd, Westampton, NJ 08060-3804 | 2016-06-13 |
| 1235593054 | Sean Jackson | Physical Therapist | 721 E Milltown Rd, Wooster, OH 44691-1331 | 2016-04-07 |
| 1831468404 | Sean Michael Jackson | Counselor | 1817 Queen Anne Ave N, #409, Seattle, WA 98109-2876 | 2011-12-27 |
| Street Address |
111 W 7 MILE RD |
| City | DETROIT |
| State | MI |
| Zip Code | 48203-1968 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851554034 | Detroit Community Health Connection, Inc | Clinic/Center | 111 W 7 Mile Rd, Detroit, MI 48203-1968 | 2008-07-08 |
| 1568737500 | Detroit Community Health Connection, Inc | Clinic/Center | 111 W 7 Mile Rd, Detroit, MI 48203-1968 | 2012-03-08 |
| 1578882999 | Jade Andrea Burns | Nurse Practitioner | 111 W 7 Mile Rd, Detroit, MI 48203-1968 | 2010-05-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992355135 | James Calloway | Peer Specialist | 1211 E Mcnichols, Detroit, MI 48203 | 2019-09-19 |
| 1851868582 | Community Veterans Services Inc | Counselor | 163 Tennyson, Highland Park, MI 48203 | 2018-10-31 |
| 1346601838 | Rainbow Center of Michigan | Health Maintenance Organization | 12501 Hamilton Ave., Highland Park, MI 48203 | 2016-03-11 |
| 1134502354 | Minds Moving In New Directions Inc | Community/Behavioral Health | 62 Massachusetts St, Highland Park, MI 48203 | 2015-07-07 |
| 1811312937 | Brea Holloway | Home Health | 20249 Yacama Rd, Detroit, MI 48203 | 2014-02-26 |
| 1770821795 | St John Providence Health Systems | Community/Behavioral Health | 1150 Lantz St, Detroit, MI 48203 | 2013-01-25 |
| 1871845412 | Waneta Darcell Dickerson | Social Worker | 169 W. Buena Vista, Highlandpark, MI 48203 | 2012-10-05 |
| 1629331939 | Maureen Connolly | Pediatrics | 77 Victor St, Highland Park, MI 48203 | 2012-06-21 |
| 1578850251 | Detroit Recovery Project | Community/Behavioral Health | 1121 East Mc Nichols, Detroit, MI 48203 | 2011-07-01 |
| 1265728414 | Barbara Suzanne Tyson | Home Health | 301 Glendale St, Apt B8, Highland Park, MI 48203 | 2011-06-27 |
| Find all providers in zip 48203 | ||||
| Taxonomy Code | 124Q00000X |
| Grouping | Dental Providers |
| Classification | Dental Hygienist |
| An individual who has completed an accredited dental hygiene education program, and an individual who has been licensed by a state board of dental examiners to provide preventive care services under the supervision of a dentist. Functions that may be legally delegated to the dental hygienist vary based on the needs of the dentist, the educational preparation of the dental hygienist and state dental practice acts and regulations, but always include, at a minimum, scaling and polishing the teeth. To avoid misleading the public, no occupational title other than dental hygienist should be used to describe this dental auxiliary. |
| Notes: Source: Comprehensive Policy Statement on Dental Auxiliaries, American Dental Association. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952941825 | Ericka Melissa Smith | Dental Hygienist | 14577 Rosemont Ave, Detroit, MI 48223-2338 | 2020-01-08 |
| 1174041990 | Doris D Ogburn | Dental Hygienist | 4727 St Antoine Street, Suite 408, Detroit, MI 48201 | 2017-08-31 |
| 1902338635 | Armanda Hendricks | Dental Hygienist | 3646 Mt Elliott St, Detroit, MI 48207 | 2017-03-31 |
| 1760857387 | Cheryl Lynn Hewison | Dental Hygienist | 4727 St. Antoine St., Ste 408, Detroit, MI 48201 | 2015-12-08 |
| 1760876270 | Angela Bernard | Dental Hygienist | 14164 Abington Ave, Detroit, MI 48227-1304 | 2015-03-23 |
| 1932502077 | Keisha Denise Parks | Dental Hygienist | 5379 Crane St, Detroit, MI 48213-2918 | 2014-10-03 |
| 1053748889 | Dental Hygiene Visiting Services | Dental Hygienist | 38 Adelaide St, Detroit, MI 48201-3111 | 2013-10-12 |
| 1942567722 | Jaclyn Smith | Dental Hygienist | 19173 Santa Barbara Dr, Detroit, MI 48221-1624 | 2012-04-18 |
| 1023399607 | Sabrina Latrice Basley | Dental Hygienist | 7633 E Jefferson Ave Ste 70, Detroit, MI 48214-3730 | 2011-09-08 |
| 1962704668 | Sheila Inez Upshaw-flowers | Dental Hygienist | 18616 W. Mcnichols, Your Family Dentist, Detroit, MI 48219 | 2010-12-01 |
| Find all providers in DETROIT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.