JACKSON FAMILY DENTAL LLC (NPI# 1851781520) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851781520 |
| Entity Type | Organization |
| Organization Name | JACKSON FAMILY DENTAL LLC |
| Practice Address |
26 S Village Dr Liberty MO 64068-2457 |
| Practice Telephone | 8164295799 |
| Mailing Telephone | 8164295799 |
| Enumeration Date | 2015-02-02 |
| Last Update Date | 2015-02-02 |
| Authorized Official Name | DR. JESSE LYNN JACKSON (MEMBER) |
| Authorized Official Telephone | 8164295799 |
| Authorized Official Credential | D.D.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Street Address |
26 S VILLAGE DR |
| City | LIBERTY |
| State | MO |
| Zip Code | 64068-2457 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336330810 | Keith David Johnson | Dentist | 26 S Village Dr, Liberty, MO 64068 | 2007-08-08 |
| 1235458514 | Jesse L Jackson | Dentist | 26 S Village Dr, Liberty, MO 64068-2457 | 2010-05-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700437258 | Midwestern Medical Consultants LLC | Assisted Living Facility | 227 W. Franklin St, Liberty, MO 64068 | 2019-09-26 |
| 1063935062 | Jennifer Nichole Gibson | Nurse Practitioner | Liberty Hospital 2525 Glen Hendren Dr, Liberty, MO 64068 | 2017-07-21 |
| 1598288755 | Lhlc Operations, LLC | Skilled Nursing Facility | 2609 Glenn Hendren Dr Ste G100, Liberty, MO 64068 | 2017-07-19 |
| 1023438371 | Sarah E Ehlers | Social Worker | 1170 W. Kansas Ave, Bldg 10, Liberty, MO 64068 | 2014-04-24 |
| 1629498563 | Kelli Hedgpeth | Physical Therapy Assistant | 3980 South Jackson Dr, Independence, MO 64068 | 2014-04-18 |
| 1639593965 | Klein Dental Group LLC | Clinic/Center | 12 Westwoods Dr, Liberty, MO 64068 | 2014-02-06 |
| 1124457239 | Sarah Ehlers, Lcsw LLC | Social Worker | 1170 W Kansas Ave, Bldg 10, Liberty, MO 64068 | 2013-11-08 |
| 1134561558 | Holly Hemphill | Marriage & Family Therapist | 117 N. Water Street, Liberty, MO 64068 | 2013-07-26 |
| 1093157133 | Tina Wilma Sanborn | Marriage & Family Therapist | 1170 W. Kansas St., Liberty, MO 64068 | 2013-07-17 |
| 1609215441 | Timothy Adam Lynch | Marriage & Family Therapist | 1170 West Kansas Ave., Liberty, MO 64068 | 2013-06-14 |
| Find all providers in zip 64068 | ||||
| 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 |
|---|---|---|---|---|
| 1194345330 | Ryan Holbrook Dds LLC | Dentist | 1504 N Church Rd Ste A, Liberty, MO 64068-7163 | 2020-04-17 |
| 1790239283 | Lauren David | Dentist | 211 Regal Ln, Liberty, TX 77575-3176 | 2016-08-12 |
| 1285901264 | Laura B Scott | Dentist | 428 Hustonville St, Liberty, KY 42539-3140 | 2011-11-19 |
| 1841586955 | David Alexander Mitts | Dentist | 105 N Stewart Ct Ste 140, Liberty, MO 64068-1397 | 2011-06-27 |
| 1972741288 | Philip E Olsen | Dentist | 68 Academy St, Liberty, NY 12754-4705 | 2009-01-23 |
| 1770736357 | Douglas M. Triplett Ddspc | Dentist | 1129 W Kansas St Ste C, Liberty, MO 64068-2297 | 2008-10-28 |
| 1336330810 | Keith David Johnson | Dentist | 26 S Village Dr, Liberty, MO 64068 | 2007-08-08 |
| 1730387655 | Lee Daniel Casey | Dentist | 162 S Broad St, Liberty, MS 39645-8059 | 2007-07-03 |
| 1396954012 | Albert Lindsay Delaney | Dentist | 1917 Cos St, Liberty, TX 77575-4801 | 2007-05-21 |
| 1376672931 | Douglas Martin Triplett | Dentist | 1129c W Kansas, Liberty, MO 64068 | 2007-03-02 |
| Find all providers in LIBERTY | ||||
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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.