DR MARILYN D JACKSON & ASSOCIATES LTD (NPI# 1336123041) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1336123041 |
Entity Type | Organization |
Organization Name | DR MARILYN D JACKSON & ASSOCIATES LTD |
Practice Address |
1705 E Sauk Trl Sauk Village IL 60411-4955 |
Mailing Address |
Po Box 1893 Chicago Heights IL 60412-1893 |
Practice Telephone | 7087573100 |
Practice Fax Number | 7087573272 |
Mailing Telephone | 7087573100 |
Mailing Fax Number | 7087573272 |
Enumeration Date | 2005-12-06 |
Last Update Date | 2020-08-22 |
Authorized Official Name | MARILYN DENISE JACKSON (DENTIST PRESIDENT OF CORPORATION) |
Authorized Official Telephone | 7087573100 |
Authorized Official Credential | DDS |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 122300000X | Dentist | 12009402 | IN | Dental Providers |
Y | 122300000X | Dentist | 01917207 | IL | Dental Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IL | 1002324 | 05 |
Street Address |
1705 E SAUK TRL |
City | SAUK VILLAGE |
State | IL |
Zip Code | 60411-4955 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1164044236 | Bryant Healthy Living, LLC | Nurse Practitioner | 19404 N. Creek Drive, Lynwood, IL 60411 | 2020-05-12 |
1235657263 | Natisha Olaseni | Case Manager/Care Coordinator | 641 W. 63rd Street, Chicago, IL 60411 | 2017-08-30 |
1033644497 | Fresenius Medical Care Chicagoland, LLC | Clinic/Center | 15 E. Independence Drive, Chicago Heights, IL 60411 | 2017-04-24 |
1992251771 | Latonya West | Counselor | 1640 215th Pl, Sauk Village, IL 60411 | 2016-08-31 |
1063868586 | Oho and Associates | Non-emergency Medical Transport (VAN) | 1010 S. Dixie Hwy, Chicago Heights, IL 60411 | 2016-05-13 |
1578945309 | Albert Ellis Jr. | Counselor | 395 West Lincoln Highway, Chicago Heights, IL 60411 | 2015-06-29 |
1407238181 | Stephanie Touney | Behavioral Analyst | 450 West 14th Street, Chicago Heights, IL 60411 | 2015-06-18 |
1851788582 | Dlw Transporation Corp | Non-emergency Medical Transport (VAN) | 603 Andover, Chicago H.t.s., IL 60411 | 2015-04-21 |
1215338983 | Stephanie Anderson-bell | Occupational Therapist | 630 Ranger Dr., Chicago Heights, IL 60411 | 2014-09-11 |
1255778221 | Aunt Martha's Youth Service Center, Inc | Clinic/Center | 500 Dixie Highway, Chicago Heights, IL 60411 | 2013-05-30 |
Find all providers in zip 60411 |
Taxonomy Code | 122300000X |
Grouping | Dental Providers |
Classification | Dentist |
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
Notes: Source: Council on Dental Education and Licensure, American Dental Association |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1124629076 | Align Dental Group PC. | Dentist | 2605 Grand Ave Ste A, Waukegan, IL 60085-2410 | 2020-11-06 |
1881293801 | Wh Il Dental Pllc | Dentist | 18086 N. Kilpatrick Ave., Chicago, IL 60639 | 2020-10-21 |
1982201505 | Ashley Rodriguez | Dentist | 2208 N Mannheim Rd, Melrose Park, IL 60164-1837 | 2020-10-06 |
1831796853 | Shaista Hasan | Dentist | 1840 Harvest Ln, Glendale Heights, IL 60139-1939 | 2020-10-02 |
1558978841 | William Mitsos Dds | Dentist | 1291 S. 7th Ave, Kankakee, IL 60901 | 2020-09-30 |
1477160190 | Smilesbysangha LLC | Dentist | 118 Barrington Commons Ct Ste 201, Barrington, IL 60010-3259 | 2020-09-27 |
1477160331 | Samer Mosoof | Dentist | 9 Monroe Ct, Streamwood, IL 60107-1365 | 2020-09-24 |
1881208478 | Poornima Swamy Gangaji | Dentist | 760 N, Illinois Rte 59, Ste100, Naperville, IL 60563 | 2020-09-01 |
1275145534 | Moondrift Sleep Solutions, LLC | Dentist | 837 N Wilke Rd, Arlington Heights, IL 60005-1047 | 2020-08-18 |
1023629664 | Mockunas Dental PC | Dentist | 13530 S Route 59 Unit 120, Plainfield, IL 60544-5659 | 2020-08-16 |
Find all providers with the same taxonomy |
City | SAUK VILLAGE |
Zip Code | 60411 |
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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.