MR. MARK K JACKSON (NPI# 1598788796) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598788796 |
| Entity Type | Individual |
| Full Name | MR. MARK K JACKSON |
| Credential | DDS |
| Practice Address |
7007 Old Sauk Road Madison WI 53717 |
| Mailing Address |
3556 Timber Lane Cross Plains WI 53528 |
| Practice Telephone | 6088332060 |
| Practice Fax Number | 6088331737 |
| Mailing Telephone | 6087983733 |
| Mailing Fax Number | 6088331737 |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
3459 | WI | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 33475100 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134755721 | Mark Wayne Jackson | Occupational Therapist | 8608 Marys Creek Dr, Benbrook, TX 76116-7624 | 2020-03-16 |
| 1811409535 | Mark Jackson | Driver | 26048 Pine Tree Rd, Rhoadesville, VA 22542-8549 | 2017-11-03 |
| 1932488194 | Mark Monroe Jackson | Social Worker | 119 Kona Dr, Galveston, TX 77554-8623 | 2011-08-05 |
| 1477860757 | Mark Allan Jackson | Technician, Other | 322 S Jefferson St, Louisa, KY 41230-1316 | 2010-09-08 |
| 1063620516 | Mark Kent Jackson | Pharmacist | 605 Hwy 31 South, Suite D, Athens, AL 35611 | 2007-05-18 |
| 1528289881 | Mark Jackson | Preventive Medicine | 10 Standing Rock Agency Avenue, Fort Yates, ND 58538 | 2007-05-02 |
| 1255470209 | Mark F Jackson | Anesthesiology | 3930 Us 1 S, Saint Augustine, FL 32086-7089 | 2007-02-06 |
| 1003877077 | Mark R. Jackson | Emergency Medicine | 1474 E Erda Way, Tooele, UT 84074-9737 | 2006-03-30 |
| 1073585238 | Mark A Jackson | Family Medicine | 1000 Pavilions Circle, Mark A Jackson Md Plc, Traverse City, MI 49684 | 2006-02-02 |
| 1023015005 | Mark D Jackson | Optometrist | 1250 E Magnolia St, Fort Collins, CO 80524-2702 | 2005-07-05 |
| Street Address |
7007 OLD SAUK ROAD |
| City | MADISON |
| State | WI |
| Zip Code | 53717 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720540164 | Apex Chiropractic Center LLC | Chiropractor | 562 Junction Road, Madison, WI 53717 | 2019-04-04 |
| 1467943795 | Brittany Macrander | Speech-Language Pathologist | 701 Deming Way, Madison, WI 53717 | 2018-05-22 |
| 1144622614 | Christopher Leclair | Pharmacist | 7942 Tree Ln, Suite 201, Madison, WI 53717 | 2014-09-16 |
| 1740617430 | Martha Darlene Kniffin | Marriage & Family Therapist | 1805 Excelsior Dr, The Family Center, Madison, WI 53717 | 2013-09-26 |
| 1740538305 | Amber J Thompson | Specialist | 8202 Excelisor Dr, Madison, WI 53717 | 2012-08-29 |
| 1457622938 | Kimberly F Lauth | Physician Assistant | 1200 Q Hammons Drive, Suite 400, Madison, WI 53717 | 2012-01-16 |
| 1699042499 | Cameron K Birch | Pharmacist | 9741 Tree Lane, Suite 201, Madison, WI 53717 | 2011-11-22 |
| 1508023102 | Katherine Jo Hartkopf | Pharmacist | 8501 Excelsior Drive, Rm. 337, Madison, WI 53717 | 2008-05-21 |
| 1366614885 | Periodontal & Implant Specialists of Madison, LLC | Dentist | 49 N Walbridge Ave., Madison, WI 53717 | 2008-03-25 |
| 1598961005 | John H Greist | Psychiatry & Neurology | Healthcare Technology Systems, Inc., 7617 Mineral Point Rd., Ste. 300, Madison, WI 53717 | 2007-06-22 |
| Find all providers in zip 53717 | ||||
| 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 |
|---|---|---|---|---|
| 1003457441 | Madison Dentistry LLC | Dentist | 268 Main Street, Suite B, Madison, NJ 07940 | 2019-10-07 |
| 1093154601 | Matthew D Reiland | Dentist | 2921 Landmark Pl Ste 100, Madison, WI 53713-4248 | 2013-06-17 |
| 1720202153 | Stephen Charles Greer II Dmd | Dentist | 401 Baptist Drive, Suite 207, Madison, MS 39110 | 2007-04-13 |
| 1164599460 | David Franklin Butler | Dentist | 505 Cragmont St, Madison, IN 47250-3003 | 2006-11-29 |
| 1891727152 | Karen S Ablow | Dentist | 145 Durham Road, Madison, CT 06443 | 2006-07-07 |
| 1851373625 | Jeffrey Scott Brown | Dentist | 106 Highland Way Ste 207, Madison, MS 39110-6930 | 2005-11-17 |
| 1700273208 | North Alabama Oral and Facial Surgery LLC | Dentist | 44 Hughes Rd, Madison, AL 35758-3045 | 2015-04-22 |
| 1174928709 | David F Butler, Dds | Dentist | 505 Cragmont St, Madison, IN 47250-3003 | 2014-10-24 |
| 1346576915 | Madison Oral and Facial Surgery, LLC | Dentist | 44 Hughes Rd, Suite 1500, Madison, AL 35758-2237 | 2009-11-02 |
| 1245416429 | Harold C. Peeples, Dds, PC | Dentist | 85 Cude Ln, Madison, TN 37115-2292 | 2008-01-17 |
| Find all providers in MADISON | ||||
Please comment or provide details below to improve the information on MR. MARK K JACKSON.
| 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.