DR. WILLIAM KENNETH JACKSON (NPI# 1417006594) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417006594 |
| Entity Type | Individual |
| Full Name | DR. WILLIAM KENNETH JACKSON |
| Credential | DDS |
| Practice Address |
11411 N Central Expy Ste K Dallas TX 75243-6606 |
| Practice Telephone | 2147395824 |
| Practice Fax Number | 2147395073 |
| Mailing Telephone | 2147395824 |
| Mailing Fax Number | 2147395073 |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2007-07-28 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
9441 | TX | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376901603 | William Jackson | Case Manager/Care Coordinator | 1001 W Broadway Ste B, Farmington, NM 87401-5638 | 2016-02-01 |
| 1104237338 | William Jackson | Surgery | 101 S Ravenel St Ste 230, Florence, SC 29506-2624 | 2014-05-09 |
| 1851646129 | William Jackson | Specialist | 5 Shorewood Ln, Centerport, NY 11721-1731 | 2012-07-23 |
| 1083904502 | William Materson Jackson | Registered Nurse | 1730 Brunswick Dr, Blacksburg, VA 24060-1988 | 2011-04-18 |
| 1912231721 | William Roland Jackson | Counselor | 2772 S. Mlk Blvd., Fresno, CA 93706-5345 | 2009-09-25 |
| 1427290667 | William E Jackson | Physician Assistant | 9261 E Northview Ct, Tucson, AZ 85749-9792 | 2009-04-02 |
| 1487846366 | William Bradley Jackson | Physical Therapy Assistant | 176 Division St, Great Barrington, MA 01230-1179 | 2007-08-14 |
| 1316144215 | William Lorenzo Jackson | Internal Medicine | 300 Rodgers Blvd, Terminal Box Unit-67, Honolulu, HI 96819-1890 | 2007-07-02 |
| 1366585226 | William Spencer Jackson | Counselor | 880 W 12th St, Reno, NV 89503-2601 | 2007-02-14 |
| 1326109661 | William Jackson Jr. | Optometrist | 4 West Way Court, Lake Jackson, TX 77566-5242 | 2006-12-12 |
| Street Address |
11411 N CENTRAL EXPY STE K |
| City | DALLAS |
| State | TX |
| Zip Code | 75243-6606 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558970830 | Nnamdi Okorie | Licensed Vocational Nurse | [email protected], 13427 Hedgeapple Dr, Dallas, TX 75243 | 2020-07-23 |
| 1629627716 | Mohammad Mehdi Imani Emadi | Dentist | 11970 N Central Expy # 430, Dallas, TX 75243 | 2019-09-10 |
| 1295221786 | Cornerstonemd,pllc | Obstetrics & Gynecology | 12222 N Central Expy Ste 140, Dallas, TX 75243 | 2018-07-08 |
| 1033609292 | Mother Earth Healthcare Services Inc | Home Health | 9821 Summerwood Cir Apt 1701, Dallas, TX 75243 | 2018-05-14 |
| 1346742822 | Chioma Ifeji | Licensed Vocational Nurse | 13317 Daystrom Court, Dallas, TX 75243 | 2018-03-01 |
| 1598282865 | Kimberly Ann Whitney | Social Worker | 11520 N Central Expy Ste 254, Dallas, TX 75243 | 2017-08-27 |
| 1962934083 | Dignity Private Care, LLC | In Home Supportive Care | 8330 Lbj Freeway, Ste 720, Dallas, TX 75243 | 2017-03-29 |
| 1699214569 | Vitalis Home Health LLC | Home Health | 9821 Summerwood Cir Apt 1308, Dallas, TX 75243 | 2017-02-13 |
| 1881130946 | Proniles | Non-emergency Medical Transport (VAN) | 12611 Hornbeam Dr, Dallas, TX 75243 | 2017-01-13 |
| 1194273664 | Osman W Awdallah | Non-emergency Medical Transport (VAN) | 12611 Hornbeam Drive, Dallas, TX 75243 | 2016-09-14 |
| Find all providers in zip 75243 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316594120 | Mona Stone Dds LLC | Dentist | 4863 Allencrest Ln, Dallas, TX 75244-7710 | 2019-08-26 |
| 1629428941 | Texas Wisdom Teeth & Dental Implants | Dentist | 14856 Preston Rd Ste 104, Dallas, TX 75254-6844 | 2016-06-17 |
| 1205253614 | John William Gannon | Dentist | 8315 Walnut Hill Ln Ste 120, Dallas, TX 75231 | 2014-03-24 |
| 1649616434 | Andrew Anthony Arango | Dentist | 8611 Hillcrest Ave Ste 235, Dallas, TX 75225-4231 | 2013-05-20 |
| 1659714228 | Danielle Gladneice Gill | Dentist | 195 W Davis St Apt 408, Dallas, TX 75208-4429 | 2013-04-12 |
| 1811280001 | Matthew James Krieger | Dentist | 5321 E Mockingbird Ln Ste 210, Dallas, TX 75206-0915 | 2011-05-19 |
| 1396063608 | Mohammed M Al-obaidi | Dentist | 3120 State St Apt J, Dallas, TX 75204-2626 | 2010-05-11 |
| 1780815365 | Randy Robert Sanovich | Dentist | 12740 Hillcrest Rd Ste 100, Dallas, TX 75230-2050 | 2009-07-31 |
| 1477782266 | Joshua Alan Stone | Dentist | 6333 Forest Park Rd # 130, Dallas, TX 75235-5461 | 2009-07-14 |
| 1467621011 | Metroplex Surgical Arts, P.a. | Dentist | 7988 W Virginia Dr Ste 200, Dallas, TX 75237-3764 | 2008-02-28 |
| Find all providers in DALLAS | ||||
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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.