JEFFREY JACKY (NPI# 1356791677) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356791677 |
| Entity Type | Individual |
| Full Name | JEFFREY JACKY |
| Credential | DENTURIST LD |
| Practice Address |
5935 Se Alexander St Hillsboro OR 97123-8575 |
| Mailing Address |
6950 Ne Campus Way Hills Boro OR 97124 |
| Practice Telephone | 8554336825 |
| Enumeration Date | 2016-06-17 |
| Last Update Date | 2017-09-29 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122400000X | Denturist | DTDO709602 | OR | Dental Providers |
| Street Address |
5935 SE ALEXANDER ST |
| City | HILLSBORO |
| State | OR |
| Zip Code | 97123-8575 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568561942 | Matthew Albert Haehlen | Dentist | 5935 Se Alexander St, Hillsboro, OR 97123-8575 | 2006-09-21 |
| 1063988558 | Elisabeth Maureen Gorman | Dentist | 5935 Se Alexander St, Hillsboro, OR 97123-8575 | 2018-10-23 |
| 1023464179 | Darren Ng | Dentist | 5935 Se Alexander St, Hillsboro, OR 97123-8575 | 2016-05-08 |
| 1598148512 | Grant Beyer | Dentist | 5935 Se Alexander St, Hillsboro, OR 97123 | 2015-07-08 |
| 1184033987 | Megan Hays | Dentist | 5935 Se Alexander St, Hillsboro, OR 97123-8575 | 2014-08-05 |
| 1821406786 | Andrew Roland | Dentist | 5935 Se Alexander St, Hillsboro, OR 97123-8575 | 2014-07-23 |
| 1952649030 | Elvera Denise Fleming-pacheco | Dental Hygienist | 5935 Se Alexander St, Hillsboro, OR 97123-8575 | 2013-01-23 |
| 1073850137 | Jeni Wilson | Dental Hygienist | 5935 Se Alexander St, Hillsboro, OR 97123-8575 | 2013-01-09 |
| 1326224726 | Vania Helmer | Dental Hygienist | 5935 Se Alexander St, Hillsboro, OR 97123-8575 | 2008-01-15 |
| 1356525638 | Sharon Louise May | Dental Hygienist | 5935 Se Alexander St, Hillsboro, OR 97123-8575 | 2007-12-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851916241 | Gabriel Lawrence | Physical Therapist | 2973 Se 79th Ave., Hillsboro, OR 97123 | 2020-06-11 |
| 1487278453 | Jordan Gregory Evans | Student in an Organized Health Care Education/Training Program | Creighton Hall 222 Se 8th Ave, Hillsboro, OR 97123 | 2020-06-04 |
| 1124641006 | Jessica Anne Bramlett | Student in an Organized Health Care Education/Training Program | 228 Southeast 8th Avenue, Suite 536, Hillsboro, OR 97123 | 2020-05-26 |
| 1003448168 | Madelyn Vogt | Community Health Worker | 862 Se Oak Street, Suite 2a, Hillsboro, OR 97123 | 2020-02-06 |
| 1215435789 | Renise Harrel | Massage Therapist | 4855 Se Tv Hwy, Suite B, Hillsboro, OR 97123 | 2018-01-30 |
| 1497260269 | Amy Hodges | Counselor | 222 Se 8th Ave # 212, Hillsboro, OR 97123 | 2017-12-02 |
| 1033623723 | Tamira L Heyob | Doula | 25600 Sw Bald Peak Rd., Hillsboro, OR 97123 | 2017-11-17 |
| 1134644024 | Tara Kyoko Taylor | Massage Therapist | 5289 Ne Elam Young Pkwy #130, Hillsboro, OR 97123 | 2017-08-11 |
| 1023543055 | Austin Simpson | Counselor | 222 Se 8th, Suite 222, Hillsboro, OR 97123 | 2017-04-27 |
| 1124569769 | Emergency Tooth Doctor Hillsboro, Prof. Corp. | Dentist | 752 Se Oak St, Hillsboro, OR 97123 | 2017-03-15 |
| Find all providers in zip 97123 | ||||
| Taxonomy Code | 122400000X |
| Grouping | Dental Providers |
| Classification | Denturist |
| Definition to come. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316576341 | Madeline M Cain | Denturist | 232 Ne Lincoln St Ste B, Hillsboro, OR 97124-3048 | 2020-04-02 |
| 1770704868 | Robert Edford Cain | Denturist | 232 Ne Lincoln, Suite B, Hillsboro, OR 97124 | 2007-05-02 |
| 1881001337 | Eugenia Trusov | Denturist | 6950 Ne Campus Way, Hillsboro, OR 97124-5611 | 2014-07-16 |
| 1609088665 | Miroslaw Antoni Zychla | Denturist | 6950 Ne Campus Way, Hillsboro, OR 97124-5611 | 2007-05-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013549575 | Christopher Scott Mayo Jr. | Denturist | 937 Chetco Ave Ste. B, Brookings, OR 97415 | 2020-02-12 |
| 1104465525 | Andrew Kyle Burzynski | Denturist | 853 Ne 4th St., Bend, OR 97701 | 2020-01-02 |
| 1063074250 | Rajeev Rugi Siddappa | Denturist | 740 Avenue H, Seaside, OR 97138-6619 | 2019-07-08 |
| 1548760630 | Stephen Depirro II | Denturist | 740 Avenue H Ste 2, Seaside, OR 97138-6603 | 2018-02-15 |
| 1770083172 | Valley Denture Care LLC | Denturist | 535 N 5th St, Jacksonville, OR 97530-9704 | 2018-02-13 |
| 1407364177 | Joseph Rider | Denturist | 1523 Nw Canal Blvd Ste 101, Redmond, OR 97756-1340 | 2018-01-16 |
| 1821503293 | Calvin Daniel Smith | Denturist | 65 Irving Rd, Eugene, OR 97404 | 2017-12-07 |
| 1841642287 | Veronika Buliga | Denturist | 6842 Se 66th Ave, Portland, OR 97206-7449 | 2016-07-11 |
| 1528435237 | Lidiya Bogdan | Denturist | 4637 Se 128th Ave, Portland, OR 97236-3713 | 2015-08-28 |
| 1407243736 | Kismet Winslow | Denturist | 553 Chetco Ln, Brookings, OR 97415-8159 | 2015-04-24 |
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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.