DR. KENNETH J JACKSON (NPI# 1396968863) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396968863 |
| Entity Type | Individual |
| Full Name | DR. KENNETH J JACKSON |
| Credential | DDS |
| Practice Address |
809 Redskin Trail Wapakoneta OH 45895 |
| Practice Telephone | 4197382426 |
| Practice Fax Number | 4197386411 |
| Mailing Telephone | 4197382426 |
| Mailing Fax Number | 4197386411 |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 20856 | OH | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174083810 | Kenneth Jason Jackson | Student in an Organized Health Care Education/Training Program | 320 23rd St S Apt 1418, Arlington, VA 22202-3773 | 2019-03-20 |
| 1639469026 | Kenneth T Jackson | Counselor | 25506 Virginia Dr, Warren, MI 48091-6002 | 2011-04-19 |
| 1972510352 | Kenneth Wayne Jackson | Nurse Practitioner | 1811 Memorial Dr, Clarksville, TN 37043-4604 | 2006-08-01 |
| 1487606943 | Kenneth Wade Jackson Jr. | Obstetrics & Gynecology | 22 Manningfield Dr, Fletcher, NC 28732-9457 | 2006-05-16 |
| 1275514994 | Kenneth Conrad Jackson II | Pharmacist | 546 Chipeta Way, Suite 220, Salt Lake City, UT 84108-1236 | 2005-11-09 |
| 1407409063 | Kenneth Jackson | Technician | 1005 Terminal Way Ste 125, Reno, NV 89502-2198 | 2019-07-22 |
| 1457857690 | Kenneth D Jackson | Counselor | 2775 State Route 39, Shelby, OH 44875-9466 | 2018-04-05 |
| 1528573714 | Kenneth Jackson | Case Manager/Care Coordinator | 1501 Madison Rd, Walnut Hills, OH 45206-1706 | 2017-12-10 |
| 1003328550 | Kenneth Lee Jackson Jr. | Counselor | 1430 S High St Fl 4, Columbus, OH 43207-1045 | 2017-10-24 |
| 1942674411 | Kenneth David Jackson Jr. | Case Manager/Care Coordinator | 3901 Ulloa St, New Orleans, LA 70119-6942 | 2015-11-21 |
| Street Address |
809 REDSKIN TRAIL |
| City | WAPAKONETA |
| State | OH |
| Zip Code | 45895 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558834119 | Dr Eric West Dc Inc | Chiropractor | 801 Brewfield Redskin Trail, Wapakoneta, OH 45895 | 2019-01-07 |
| 1063931624 | Teresa Howell | Home Health | 15500 Bay Road, Wapakoneta, OH 45895 | 2017-09-14 |
| 1891241410 | Dion Michael Paul | Occupational Therapy Assistant | 305 East Mechanic St., Wapakoneta, OH 45895 | 2016-09-01 |
| 1609235480 | Marianne Morrisey | Speech-Language Pathologist | 1010 Lincoln Ave, Wapakoneta, OH 45895 | 2016-02-22 |
| 1700285327 | Brittany Kay Clark | Nurse Practitioner | 1258 Bellefontaine St Ste A, Wapakoneta, OH 45895 | 2014-08-19 |
| 1871896621 | Barbara Jill Cummins | Family Medicine | 807 Glynwood Road, Wapakoneta, OH 45895 | 2010-12-17 |
| 1649410630 | Michael Justin Nagel | Chiropractor | 801 Brewfield Dr., Redskin Trail, Wapakoneta, OH 45895 | 2009-03-03 |
| 1538331475 | Alliance for Women's Health Inc | Obstetrics & Gynecology | 1251 Lincoln Avenue, Wapakoneta, OH 45895 | 2008-04-01 |
| 1275745754 | New Vision Nursing and Home Care LLC | Home Health | 310 Perry St, Wapakoneta, OH 45895 | 2007-05-04 |
| 1346461886 | Rudolph Lewis Vostatek | Dentist | 1101 Defiance Street, Wapakoneta, OH 45895 | 2007-05-01 |
| Find all providers in zip 45895 | ||||
| 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 |
|---|---|---|---|---|
| 1780716845 | Timothy David Meyer | Dentist | 1106 Lincoln Hwy, Wapakoneta, OH 45895 | 2007-03-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598372583 | Jacob Falter | Dentist | 4818 Hillcrest St S, Hilliard, OH 43026-1610 | 2020-09-24 |
| 1508476409 | Holpuch Dental Inc | Dentist | 340 Ridge Rd Ste 2, Newton Falls, OH 44444-1264 | 2020-08-05 |
| 1336758762 | Swati Verma | Dentist | 9850 Colerain Ave, Cincinnati, OH 45251-1470 | 2020-07-31 |
| 1508484320 | Kayla Fike D.d.s. LLC | Dentist | 5311 Broadview Rd, Parma, OH 44134-1617 | 2020-07-08 |
| 1942827084 | Emily Glor | Dentist | 1320 Mercy Drive Northwest, Attn: Dental Services, Canton, OH 44708 | 2020-07-05 |
| 1346867132 | Ashley Nicole Billings | Dentist | 4640 W Alexis Rd Ste 200, Toledo, OH 43623-1182 | 2020-06-29 |
| 1962028456 | Hiralben Patel | Dentist | 125 Amy Dr, Bryan, OH 43506-9086 | 2020-06-19 |
| 1942825815 | James Zaiger | Dentist | 73 W 5th Ave, Columbus, OH 43201-3218 | 2020-06-16 |
| 1831713015 | Matthew T Chaney | Dentist | 720 W 3rd Ave Apt 207, Columbus, OH 43212-3157 | 2020-06-03 |
| 1417570250 | Julissa E Burgos | Dentist | 5046 Turney Rd, Garfield Heights, OH 44125-2503 | 2020-05-27 |
| Find all providers with the same taxonomy | ||||
| City | WAPAKONETA |
| Zip Code | 45895 |
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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.