DR. JEROME ADRIAN JACKSON JR. (NPI# 1659855914) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659855914 |
| Entity Type | Individual |
| Full Name | DR. JEROME ADRIAN JACKSON JR. |
| Credential | DDS |
| Practice Address |
2100 Miller Park Way West Milwaukee WI 53219-1641 |
| Mailing Address |
62 Corporate Dr # 4401 Bangor ME 04401-4360 |
| Practice Telephone | 4146454540 |
| Practice Fax Number | 4146456380 |
| Mailing Telephone | 2079477503 |
| Enumeration Date | 2018-09-21 |
| Last Update Date | 2019-09-24 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
1002003 | WI | Dental Providers |
| N | 1223G0001X |
Dentist Specialization: General Practice |
DEN4663 | ME | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245841303 | Jerome Christopher Jackson | Non-emergency Medical Transport (VAN) | 314 Canaan Cir, Suffolk, VA 23435-3536 | 2020-08-12 |
| 1740815497 | Jerome Alexander-terrell Jackson | Respite Care | 9680 W Northern Ave Unit 2311, Peoria, AZ 85345-4655 | 2020-03-03 |
| 1235414202 | Jerome Sean Jackson | Pharmacist | 1198 W. Kemper Road, Walgreens, Cincinnati, OH 45224 | 2011-10-20 |
| 1518292796 | Jerome Ester Jackson | Counselor | 3838 N West Ave, Fresno, CA 93705-2703 | 2009-10-06 |
| 1639678196 | Jerome Santos Jackson | Technician | 1951 Stella Lake St Ste 36, Las Vegas, NV 89106-2144 | 2018-02-09 |
| Street Address |
2100 MILLER PARK WAY |
| City | WEST MILWAUKEE |
| State | WI |
| Zip Code | 53219-1641 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285679944 | Patrick R Kaul | Dentist | 2100 Miller Park Way, West Milwaukee, WI 53219-1641 | 2006-06-18 |
| 1922616002 | Thomas J. Moscinski | Dentist | 2100 Miller Park Way, West Milwaukee, WI 53219-1641 | 2020-07-15 |
| 1962980102 | Nina Rakowsky | Dentist | 2100 Miller Park Way, West Milwaukee, WI 53219-1641 | 2018-07-31 |
| 1356895593 | Wendy Zhu | Dentist | 2100 Miller Park Way, West Milwaukee, WI 53219-1641 | 2016-08-04 |
| 1184084055 | Joshua Hassan | Dentist | 2100 Miller Park Way, West Milwaukee, WI 53219-1641 | 2016-03-04 |
| 1043612328 | Ami Inoue | Dentist | 2100 Miller Park Way, West Milwaukee, WI 53219-1641 | 2014-09-18 |
| 1699192252 | Inas Murrar | Dentist | 2100 Miller Park Way, West Milwaukee, WI 53219-1641 | 2014-03-20 |
| 1801183371 | Omar Arshad | Dentist | 2100 Miller Park Way, West Milwaukee, WI 53219-1641 | 2011-07-06 |
| 1346535002 | Laura Elizabeth Goodell | Dentist | 2100 Miller Park Way, West Milwaukee, WI 53219-1641 | 2011-06-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588262323 | Tammi T Wisniewski | Hearing Instrument Specialist | 4847 W. Forest Home Avenue, Greenfield, WI 53219 | 2020-10-14 |
| 1174052344 | Adam Blaha | Physical Therapy Assistant | 2622 South 66th Street, Milwaukee, WI 53219 | 2017-06-09 |
| 1700281920 | Mary Beth Menarek | Counselor | 6574 W. Beloit Road, West Allis, WI 53219 | 2014-10-30 |
| 1780959767 | James Stanley Ziolkowski | Electrodiagnostic Medicine | 9330 W. Lincln Ave, West Allis, WI 53219 | 2012-03-09 |
| 1568752707 | Carey M Kromarek | Social Worker | 5757 W. Oklahoma Ave, Suite 203, Milwaukee, WI 53219 | 2011-04-08 |
| 1275834988 | Debra L Felzer | Registered Nurse | 7123 W Stuth Place, West Allis, WI 53219 | 2010-11-11 |
| 1528290327 | Miguel Angel Bautista | Acupuncturist | 4318 W. Foresthowe Ave., Milwaukee, WI 53219 | 2009-08-13 |
| 1629211487 | Ruth Irene Young | Physical Therapy Assistant | 2027 S. 79th Street, West Allis, WI 53219 | 2009-04-09 |
| 1053591818 | Linda St. Louis | Nurse Practitioner | 6030 W. Oklahoma Avenue, Milwaukee, WI 53219 | 2007-11-09 |
| 1811185812 | John Stuart Lanham | Podiatrist | 5720 W Oklahoma Avenue, Milwaukee, WI 53219 | 2007-10-04 |
| Find all providers in zip 53219 | ||||
| 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 |
|---|---|---|---|---|
| 1770670309 | James Edward Funke | Dentist | 4701 West National Avenue, West Milwaukee, WI 53214-3521 | 2006-10-06 |
| 1285679944 | Patrick R Kaul | Dentist | 2100 Miller Park Way, West Milwaukee, WI 53219-1641 | 2006-06-18 |
| 1922616002 | Thomas J. Moscinski | Dentist | 2100 Miller Park Way, West Milwaukee, WI 53219-1641 | 2020-07-15 |
| 1962980102 | Nina Rakowsky | Dentist | 2100 Miller Park Way, West Milwaukee, WI 53219-1641 | 2018-07-31 |
| 1356895593 | Wendy Zhu | Dentist | 2100 Miller Park Way, West Milwaukee, WI 53219-1641 | 2016-08-04 |
| 1699192252 | Inas Murrar | Dentist | 2100 Miller Park Way, West Milwaukee, WI 53219-1641 | 2014-03-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700496007 | Elizabeth R Friend | Dentist | 440 Science Dr Ste 100, Madison, WI 53711-1064 | 2020-08-03 |
| 1205451598 | Tysen Wood | Dentist | 605 S 24th Ave Ste 10, Wausau, WI 54401-1705 | 2020-06-11 |
| 1841814035 | Vicki Shah | Dentist | 220 E Commerce Ct, Elkhorn, WI 53121-4371 | 2020-06-03 |
| 1790308666 | Michelle Zellmer | Dentist | 333 W Brown Deer Rd Ste A, Fox Point, WI 53217-2370 | 2020-05-26 |
| 1568083772 | Kolver Matos | Dentist | N112w16286 Mequon Rd, Germantown, WI 53022-3306 | 2020-04-28 |
| 1205466737 | Leyes Robers Dental LLC | Dentist | 3216 W County Rd Kk, Appleton, WI 54915 | 2020-01-23 |
| 1972133536 | Neha Solanki | Dentist | 1212 Horton St Ste 200, La Crosse, WI 54601-6289 | 2020-01-23 |
| 1023655131 | Pak Dental LLC | Dentist | 8241 S Howell Ave Ste 100, Oak Creek, WI 53154-8346 | 2019-12-09 |
| 1700428216 | Binninger Dentistry, LLC | Dentist | 12720 W North Ave Bldg B, Brookfield, WI 53005-4637 | 2019-10-16 |
| 1720629017 | Quirt Family Dentistry, S.c. | Dentist | W178n9379 Water Tower Pl, Menomonee Falls, WI 53051-8034 | 2019-10-08 |
| Find all providers with the same taxonomy | ||||
| City | WEST MILWAUKEE |
| Zip Code | 53219 |
Please comment or provide details below to improve the information on DR. JEROME ADRIAN JACKSON JR..
| 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.