DR. BRANDON JOSHUA JACKSON


Address: 70 Virginia Ave, Staten Island, NY 10305-1748
Phone: 7182268851

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).

Provider Overview

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

Taxonomy

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

Other Provider Identifier

State Issuer Identifier Type Code
NY 390200000X 05

Other Providers BRANDON JACKSON

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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

Office Location

Street Address 70 VIRGINIA AVE
City STATEN ISLAND
State NY
Zip Code 10305-1748

Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 1223P0221X
Grouping Dental Providers
Classification Dentist
Specialization Pediatric Dentistry

Taxonomy Definition

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

Providers in the same taxonomy and city

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

Competitor

Search similar providers

City STATEN ISLAND
Zip Code 10305

Improve Information

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Dataset Information

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.

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