DR. BRANDON JOSHUA JACKSON (NPI# 1861753949) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1861753949 |
Entity Type | Individual |
Full Name | DR. BRANDON JOSHUA JACKSON |
Credential | D.D.S |
Practice Address |
70 Virginia Ave Staten Island NY 10305-1748 |
Mailing Address |
70 Virginia Ave Staten Island NY 10305 |
Practice Telephone | 7182268851 |
Mailing Telephone | 9176263507 |
Enumeration Date | 2012-06-05 |
Last Update Date | 2015-09-15 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
056966-1 | NY | Dental Providers |
N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care | ||
N | 390200000X | Student in an Organized Health Care Education/Training Program | NY | Student, Health Care |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NY | 390200000X | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1275046153 | Brandon Lamarr Jackson | Home Health Aide | 400 Brunswick St, Mooresville, NC 28115-2246 | 2017-11-14 |
1083163521 | Brandon Jackson | Student in an Organized Health Care Education/Training Program | 122 Lanier Dr, 322c, Statesboro, GA 30458-0804 | 2016-09-26 |
1881030310 | Brandon Christopher Jackson | Military Health Care Provider | 6810 Camphor Ln, San Diego, CA 92139 | 2013-05-10 |
1952340671 | Brandon Leroy Jackson | Physical Therapist | 4765 S. Durango Dr., Ste 106, Las Vegas, NV 89147 | 2006-06-06 |
1457994634 | Brandon Jackson | Rehabilitation Practitioner | 1873 W 54th St, Los Angeles, CA 90062-2604 | 2019-10-21 |
1427611151 | Brandon Clark Jackson | Social Worker | 42-77 65th Place, Woodside, NY 11377-5054 | 2019-04-18 |
1831658640 | Brandon Thomas Jackson | Plastic Surgery | 251 E Huron St, Chicago, IL 60611-3055 | 2019-03-19 |
1164952644 | Brandon Scott Jackson | Behavior Technician | 1200 W South Boulder Rd Ste 204, Lafayette, CO 80026-2833 | 2017-06-15 |
1578896031 | Brandon T. Jackson | Chiropractor | 1258 Bryan Rd, O Fallon, MO 63366-3771 | 2009-09-15 |
Street Address |
70 VIRGINIA AVE |
City | STATEN ISLAND |
State | NY |
Zip Code | 10305-1748 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1972101517 | Gina Sinchi | Specialist | 120 Hylan Blvd Suite 9b1, Staten Island, NY 10305 | 2020-10-15 |
1003436783 | Ali Kassem | Student in an Organized Health Care Education/Training Program | 475 Seaview University, Staten Island, New York, Staten Island University Hospital, Department of Intern, Staten Island, Nyc, NY 10305 | 2020-04-22 |
1174183982 | Mohammad Ass'ad Alshami | Student in an Organized Health Care Education/Training Program | 475 Seaview Avenue Ht-257(back), Staten Island-nyc, NY 10305 | 2019-06-14 |
1639632508 | Abdullah Jahangir | Student in an Organized Health Care Education/Training Program | 475 Seaview Avenue Staten Island, Staten Island Univers, New York City, NY 10305 | 2019-04-09 |
1922593813 | Ifeyinwa Mary Asuzu | Student in an Organized Health Care Education/Training Program | 1 Edgewater Plaza Staten Island, New York, NY 10305 | 2018-06-25 |
1700377652 | Celeste Jude Chow | Speech-Language Pathologist | 841 Father Capodanno Blvd, Staten Island, NY 10305 | 2018-05-27 |
1972094878 | Mahmoud Shadi | Student in an Organized Health Care Education/Training Program | 475 Seaview Avenue; Staten Island Univeristy Hospital, Staten Island, NY 10305 | 2018-05-25 |
1396235131 | Samyak Hiteshkumar Dhruv | Student in an Organized Health Care Education/Training Program | 475 Seaview Avenue, Staten Island, NY 10305 | 2018-05-17 |
1720583404 | Michele Corrado | Nurse Practitioner | 27 Xenia St, Staten Island, NY 10305 | 2018-03-26 |
1861995912 | Erika Renick | Dietitian, Registered | 256 Mason Avenue, Building C - 3rd Floor, Staten Island, NY 10305 | 2018-03-15 |
Find all providers in zip 10305 |
Taxonomy Code | 1223P0221X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | Pediatric Dentistry |
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
Notes: Source: Council on Dental Education and Licensure, American Dental Association |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1841849965 | Woodrow Little Smiles Family Dentistry P.C. | Dentist | 739 Woodrow Road, Staten Island, NY 10312 | 2019-09-11 |
1003054370 | Rachel Iospa | Dentist | 39 Heinz Ave, Staten Island, NY 10308-3329 | 2009-01-26 |
1689873614 | Abhinav Nath Sinha | Dentist | 6795 Hylan Blvd, Staten Island, NY 10309-3819 | 2007-07-11 |
1508994898 | Phyllis Gina Merlino | Dentist | 268 Todt Hill Rd, Staten Island, NY 10314-5532 | 2007-03-01 |
1174668503 | Alan Alterman | Dentist | 3611 Richmond Ave, Staten Island, NY 10312-3410 | 2007-02-21 |
1265495634 | Michelle Giumenta | Dentist | 2530 Amboy Rd, Staten Island, NY 10306-2220 | 2006-04-07 |
1316935505 | Deborah Gries | Dentist | 195 Bridgetown St, Staten Island, NY 10314-6006 | 2005-10-11 |
1174124291 | Sweet Tooth Pediatric Dentistry | Dentist | 6795 Hylan Blvd, Staten Island, NY 10309-3819 | 2020-11-04 |
1952756892 | Allison Paige Blutstein | Dentist | 475 Seaview Ave, Staten Island, NY 10305-3436 | 2016-04-28 |
1487009742 | Lisa Nicole Schneider | Dentist | 475 Seaview Ave, Staten Island, NY 10305-3436 | 2016-04-24 |
Find all providers in STATEN ISLAND |
City | STATEN ISLAND |
Zip Code | 10305 |
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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.