DR. CARL JACKSON JR. (NPI# 1265510457) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265510457 |
| Entity Type | Individual |
| Full Name | DR. CARL JACKSON JR. |
| Credential | DDS |
| Practice Address |
145 Pelham Dr Columbia SC 29209-1321 |
| Practice Telephone | 8036618412 |
| Practice Fax Number | 8036618415 |
| Mailing Telephone | 8036618412 |
| Mailing Fax Number | 8036618415 |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2012-07-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | 12010844A | IN | Dental Providers |
| Y | 1223G0001X |
Dentist Specialization: General Practice |
7045 | SC | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | PENDING | 05 | |
| IN | 200865730A | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285848309 | Carl Dennis Jackson | Dentist | 3200 Concord Rd, Suite 200, Aston, PA 19014-1931 | 2007-05-09 |
| 1831208768 | Carl E. Jackson | Surgery | 386 Medway Rd, Highland Heights, OH 44143-3734 | 2006-08-30 |
| 1902263270 | Carl Jackson | Physician Assistant | 8801 S 101st East Ave, Tulsa, OK 74133-5716 | 2016-01-18 |
| 1891078671 | Carl Edward Jackson | Counselor | 120 W Broadway St, Altus, OK 73521-3802 | 2011-09-28 |
| Street Address |
145 PELHAM DR |
| City | COLUMBIA |
| State | SC |
| Zip Code | 29209-1321 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811911076 | Carol Y. Smith-brown | Dentist | 145 Pelham Dr, Columbia, SC 29209-1321 | 2006-07-27 |
| 1376095885 | Anna T. Fuller, Dmd, LLC | Dentist | 145 Pelham Dr, Columbia, SC 29209-1321 | 2016-11-01 |
| 1023345188 | G Abrams and R Cohen Sc 1 PC | Dentist | 145 Pelham Dr, Columbia, SC 29209-1321 | 2009-11-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992293013 | Pertile Group LLC | Family Medicine | 26 Foot Point Rd, Columbia, SC 29209 | 2018-04-24 |
| 1083156061 | Derek Clark | Physical Therapist | 6349 Garners Ferry Rd, Columbia, SC 29209 | 2016-11-08 |
| 1922450345 | Heather Alexander | Social Worker | 6439 Garners-ferry Road, Suite 122, Wjb Dorn Va, Columbia, SC 29209 | 2016-07-09 |
| 1265888325 | Daphne Elaine Allen | Counselor | 1850 Pinview Dr, Columbia, SC 29209 | 2016-05-09 |
| 1659757649 | Marc Edmundson | Pharmacist | 500 Gills Creek Pkwy #810, Columbia, SC 29209 | 2015-08-03 |
| 1477949113 | Winter Years Home Health Care Agency, LLC | Home Health | 1101 1st Street, P, Columbia, SC 29209 | 2015-04-09 |
| 1285045773 | Alireza Adhami | Pharmacist | 7235 Garners Ferry Rd, Columbia, SC 29209 | 2014-05-19 |
| 1790039212 | Immediate Dental Group Columbia | Dentist | 1118 Greenlawn Drive, Columbia, SC 29209 | 2012-11-06 |
| 1275896284 | Tariq Horani | Internal Medicine | 6349 Garners Ferry Road, Int Med -, Columbia, SC 29209 | 2012-06-25 |
| 1902165467 | Medcare Urgent Care Center Garners Ferry, LLC | Clinic/Center | 7418 Garners Ferry Road, Columbia, SC 29209 | 2012-05-03 |
| Find all providers in zip 29209 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184239832 | Adam Wesley Gadbois | Dentist | 220 Diego Dr, Columbia, MO 65203-4919 | 2020-09-10 |
| 1841803855 | Craig Thomas Luskey | Dentist | 4500 Stuart St Fl 3, Columbia, SC 29207-5700 | 2020-08-28 |
| 1710505169 | Dentists of Devine, PC | Dentist | 4600 Devine St Ste B, Columbia, SC 29205-3617 | 2020-07-13 |
| 1134745227 | Kayla White | Dentist | 1401 Forum Blvd Ste 203, Columbia, MO 65203-1915 | 2020-06-24 |
| 1962033001 | Ivy Creek Family Dentistry LLC | Dentist | 9007 Two Notch Rd Ste B, Columbia, SC 29223-5834 | 2020-01-28 |
| 1538701230 | Sulekha Agrawal Dmd LLC | Dentist | 9194 Red Branch Rd Ste A, Columbia, MD 21045-2005 | 2019-10-14 |
| 1619522794 | Timothy Drew Edwards | Dentist | 122 N. Brickyard Rd, Columbia, SC 29223 | 2019-08-06 |
| 1245885284 | Mana Shoeybi | Dentist | 6955 Oakland Mills Rd Ste 0, Columbia, MD 21045-5849 | 2019-08-06 |
| 1528628716 | Soh of Missouri Samson Liu PC | Dentist | 303 N Keene St # 202-210, Columbia, MO 65201-8050 | 2019-06-19 |
| 1417511783 | Molly Kayleen Pincelli | Dentist | Ph Usc Medical Group Dentistry, 10 Medical Park, Columbia, SC 29203 | 2019-04-23 |
| Find all providers in COLUMBIA | ||||
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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.