DR. HARRY KEITH JACKSON (NPI# 1336234640) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336234640 |
| Entity Type | Individual |
| Full Name | DR. HARRY KEITH JACKSON |
| Credential | D.D.S. |
| Practice Address |
116 Hills Plz Charleston WV 25387-2438 |
| Mailing Address |
97 Great Teays Blvd Ste 6 Scott Depot WV 25560-9816 |
| Practice Telephone | 3047204466 |
| Practice Fax Number | 3047204813 |
| Mailing Telephone | 3047204466 |
| Mailing Fax Number | 3047204813 |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2019-08-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
2140 | WV | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WV | 0135354000 | 05 | |
| WV | 1336234640 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710467659 | Harry Lee Jackson | Counselor | 17845 Ironwood Lane, Victorville, CA 92395-9239 | 2018-08-20 |
| 1376505578 | Harry J. Jackson | Dentist | Hqs, Usa Dentac, 4441 Service Drive, Ft Hood, TX 76544-5054 | 2006-04-04 |
| 1457331209 | Harry Jackson | Legal Medicine | 140 Alcott Pl, Bronx, NY 10475-4302 | 2006-01-18 |
| Street Address |
116 HILLS PLZ |
| City | CHARLESTON |
| State | WV |
| Zip Code | 25387-2438 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750382297 | Brian Wayne Macaulay | Family Medicine | 116 Hills Plz, Charleston, WV 25387-2438 | 2005-08-09 |
| 1033741855 | Sarah Elizabeth Shapero | Counselor | 116 Hills Plz, Charleston, WV 25387-2438 | 2020-02-10 |
| 1174164115 | Susan A Bailey | Counselor | 116 Hills Plz, Charleston, WV 25387-2438 | 2019-10-01 |
| 1659842912 | Tina L Faber | Social Worker | 116 Hills Plz, Charleston, WV 25387-2438 | 2018-12-16 |
| 1326524323 | Hannah R Hudson | Nurse Practitioner | 116 Hills Plz, Charleston, WV 25387-2438 | 2018-07-13 |
| 1720530074 | Rhoda Hamilton | Nurse Practitioner | 116 Hills Plz, Charleston, WV 25387-2438 | 2016-11-02 |
| 1427502632 | Suzanne Riley | Social Worker | 116 Hills Plz, Charleston, WV 25387-2438 | 2016-08-05 |
| 1932508413 | Elizabeth C Frampton | Social Worker | 116 Hills Plz, Charleston, WV 25387-2438 | 2014-08-20 |
| 1912317629 | Lisa A. Kelly | Nurse Practitioner | 116 Hills Plz, Charleston, WV 25387-2438 | 2014-05-02 |
| 1629322524 | Casey Jo Breedlove-miller | Physician Assistant | 116 Hills Plz, Charleston, WV 25387-2438 | 2012-10-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679792493 | Letitia Elaine Tierney | Internal Medicine | Familycare Health Center, 116 N. Hills Plaza, Charleston, WV 25387 | 2007-04-24 |
| 1427661651 | James Michael Adkins | Technician | 1029 Nease Dr, Charleston, WV 25387-1007 | 2020-08-27 |
| 1578964474 | Resilience Home Care Services, LLC | Home Health | 3700 Washington St W, Charleston, WV 25387-1121 | 2014-09-10 |
| 1205448610 | Christiana E Sovine | Technician | 3902 Washington St W, Charleston, WV 25387-1123 | 2020-08-18 |
| 1245841360 | Nellie Mae Ford | Technician | 802 N Hills Dr, Charleston, WV 25387-1230 | 2020-08-12 |
| 1255941316 | Itai Gravely | Technician | 1863 Sugar Creek Dr, Charleston, WV 25387-1344 | 2020-08-04 |
| 1437513538 | Paula Mooney | Social Worker | 862 Hanna Dr, Charleston, WV 25387-1402 | 2016-04-05 |
| 1952649071 | Enact, Inc. | Case Management | 1701 5th Ave Ste 7, Charleston, WV 25387-1900 | 2013-01-24 |
| 1609045400 | Womencare, Inc | Clinic/Center | 1701 5th Ave, Charleston, WV 25387-1900 | 2008-02-26 |
| 1457967200 | Tameika M Mcneil | Technician | 113 Mcvey Way, Charleston, WV 25387-2168 | 2020-09-17 |
| Find all providers in zip 25387 | ||||
| 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 |
|---|---|---|---|---|
| 1265039754 | Ravi Bhupen Patel | Dentist | 1755 Central Park Rd, Unit 1107, Charleston, SC 29412-2846 | 2020-10-07 |
| 1598372864 | Dental Professional of South Carolina, P.C. | Dentist | 1417 Folly Rd Ste 402, Charleston, SC 29412-9737 | 2020-09-30 |
| 1023627619 | Dental Professional of South Carolina, P.C. | Dentist | 702 Hopewell Dr, Charleston, SC 29492-7102 | 2020-07-29 |
| 1427673946 | Leslie Jordan Mcgarity | Dentist | 29 Bee Street Dc 271 Msc 507, Charleston, SC 29425-0001 | 2020-06-10 |
| 1629691449 | Tgd-west Ashley LLC | Dentist | 2048 Sam Rittenberg Blvd Ste 2, Charleston, SC 29407-4673 | 2020-05-27 |
| 1922650647 | Kinnara Vasamsetti Emmons | Dentist | 46 Queen St Apt B, Charleston, SC 29401-2805 | 2019-07-12 |
| 1932769189 | John Fitzgerald | Dentist | 26 Bee Street Msc 507 Dental Clinic Room 550, Charleston, SC 29425-0001 | 2019-06-19 |
| 1144880808 | Miranda Jo Ferrari | Dentist | 3 Creekstone Rdg, Charleston, WV 25309-8986 | 2019-06-15 |
| 1114586054 | Charleston Dental Associates, LLC | Dentist | 915 Saint Andrews Blvd, Charleston, SC 29407-7138 | 2019-06-12 |
| 1285123471 | Burgess Dental | Dentist | 405 Capitol Street, The Parlor Suite, Charleston, WV 25301 | 2018-05-03 |
| Find all providers in CHARLESTON | ||||
| City | CHARLESTON |
| Zip Code | 25387 |
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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.