DR MARILYN D JACKSON & ASSOCIATES LTD


Address: 1705 E Sauk Trl, Sauk Village, IL 60411-4955
Phone: 7087573100

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 122300000X Dentist 12009402 IN Dental Providers
Y 122300000X Dentist 01917207 IL Dental Providers

Other Provider Identifier

State Issuer Identifier Type Code
IL 1002324 05

Office Location

Street Address 1705 E SAUK TRL
City SAUK VILLAGE
State IL
Zip Code 60411-4955

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Taxonomy Information

Taxonomy Code 122300000X
Grouping Dental Providers
Classification Dentist

Taxonomy Definition

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

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Competitor

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City SAUK VILLAGE
Zip Code 60411

Improve Information

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Dataset Information

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.

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