ALICIA RENEE JACKSON (NPI# 1710381256) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710381256 |
| Entity Type | Individual |
| Full Name | ALICIA RENEE JACKSON |
| Credential | DDS |
| Practice Address |
65 Broadway Ste 901 New York NY 10006-2535 |
| Mailing Address |
233 E Jericho Tpke Huntington Station NY 11746-7307 |
| Practice Telephone | 6468130645 |
| Mailing Telephone | 6314274327 |
| Enumeration Date | 2014-10-13 |
| Last Update Date | 2020-05-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 057371-1 | NY | Dental Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 233 E Jericho Tpke, Huntington Station, NY 117467307 | 6314274327 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235786377 | Alicia Nykia Jackson | Nurse Practitioner | 3060 Windward Way, Miramar, FL 33025-4293 | 2019-08-22 |
| 1689913147 | Alicia Jackson | Counselor | 79 W Alexandrine, Detroit, MI 48201-2015 | 2013-02-04 |
| 1972876555 | Alicia Jackson | Registered Nurse | 10731 130th St, South Richmond Hill, NY 11419-3131 | 2012-02-13 |
| 1992964373 | Alicia Jackson | Case Manager/Care Coordinator | 1027 Audubon Pkwy, Louisville, KY 40213-1303 | 2008-06-02 |
| 1346856408 | Alicia Michelle Jackson | Nurse Practitioner | 605 W Campbell Rd, Richardson, TX 75080-3302 | 2020-09-23 |
| 1780237099 | Alicia Jeree Jackson | Counselor | 901 Us Highway 68 Ste 900, Maysville, KY 41056-9190 | 2019-07-17 |
| 1609431667 | Alicia Jackson | Health Educator | 26901 Beaumont Blvd, Southfield, MI 48033-3849 | 2019-05-06 |
| 1912386525 | Alicia M. Jackson | Counselor | 6707 Embarcadero Dr, Stockton, CA 95219-3382 | 2015-05-28 |
| 1902245988 | Alicia J Jackson | Massage Therapist | 11200 N Portland Ave, Oklahoma City, OK 73120-5045 | 2013-06-23 |
| 1659622975 | Alicia Jackson | Counselor | 720 14th Ave., Longview, WA 98632 | 2012-09-26 |
| Street Address |
65 BROADWAY STE 901 |
| City | NEW YORK |
| State | NY |
| Zip Code | 10006-2535 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588983019 | Kiwon Lee | Dentist | 65 Broadway Ste 901, New York, NY 10006-2535 | 2010-05-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720620313 | Retina Labs (usa), Inc. | Technician/Technologist | 165 Broadway - One Liberty Plaza, Suite 2301, New York City, NY 10006 | 2019-10-15 |
| 1437626140 | Conscientiamd PC | Psychiatry & Neurology | 115 Broadway Suite 1800 (room 25), New York, NY 10006 | 2018-10-31 |
| 1720563232 | Harveen Kaur | Physical Therapist | 65 Broadway, Ste. 603, New York, NY 10006 | 2018-10-01 |
| 1871032367 | Joanne Herskovits | Speech-Language Pathologist | 90 Trinity Place, Leadership and Public Service High School, New York, NY 10006 | 2017-02-16 |
| 1457801318 | Lifetime Physical Therapy | Clinic/Center | 2 Rector St # 1301, Lifetime Physical Therapy, New York, NY 10006 | 2016-10-04 |
| 1649647959 | Progyny, Inc. | Exclusive Provider Organization | 1 Liberty Plaza, 47th Floor, New York, NY 10006 | 2015-08-24 |
| 1801207022 | Jane Arkinstall | Social Worker | 39 Broadway Suite 200, Mjhs, New York, NY 10006 | 2014-05-09 |
| 1487077665 | Jacob Perlow Hospice | Medicare Defined Swing Bed Unit | 39 Broadway, Suite 200, Ny, NY 10006 | 2014-01-24 |
| 1003249301 | Calvin C. Krom IIi | Emergency Medicine | 39 Broadway Fl 3, New York, NY 10006 | 2013-08-10 |
| 1740535103 | Carol Lynn Say Tan | Physical Therapist | 61 Broadway Suite 2824, New York, NY 10006 | 2012-07-20 |
| Find all providers in zip 10006 | ||||
| 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 |
|---|---|---|---|---|
| 1255938551 | Steven Kauftheil Dds Pllc | Dentist | 630 5th Ave Ste 1815, New York, NY 10111-1872 | 2020-10-08 |
| 1104436690 | Maryam Ghorbani | Dentist | 40 Waterside Plz Apt 12b, New York, NY 10010-2636 | 2020-08-09 |
| 1649896416 | Adam M Nusblatt, Dmd PC | Dentist | 60 E 9th St Apt 206, New York, NY 10003-6403 | 2020-06-17 |
| 1265076186 | Om Dental Arts, Pllc | Dentist | 405 Lexington Ave Fl 54, New York, NY 10174-0002 | 2019-11-04 |
| 1497399877 | Dr. F Sanchez Dental Arts Pllc | Dentist | 2 Saint Nicholas Terrace, Store #1, New York, NY 10027 | 2019-10-29 |
| 1922640911 | Suite 229 Dental Pllc | Dentist | 150 Broadway Rm 1310, New York, NY 10038-4365 | 2019-10-11 |
| 1952950123 | Lumia Dental, Pllc | Dentist | 160 Broadway Rm 1004, New York, NY 10038-4213 | 2019-09-10 |
| 1013560838 | Julie Bai | Dentist | 139 Centre St Ste 306, New York, NY 10013-4554 | 2019-07-21 |
| 1659938397 | Fanney Pereyra | Dentist | 2265 Third Avenue, New York, NY 10035 | 2019-05-28 |
| 1396301503 | Daria Vasilyeva | Dentist | 625 W 169th St Apt 51a, New York, NY 10032-0489 | 2019-05-13 |
| Find all providers in NEW YORK | ||||
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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.