JACK T ACKERMAN (NPI# 1922084276) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922084276 |
| Entity Type | Individual |
| Full Name | JACK T ACKERMAN |
| Credential | DDS |
| Practice Address |
19059 Valley Blvd Suite 103 Bloomington CA 92316-2219 |
| Practice Telephone | 9098773660 |
| Practice Fax Number | 9098773682 |
| Mailing Telephone | 9098773660 |
| Mailing Fax Number | 9098773682 |
| Enumeration Date | 2005-12-19 |
| Last Update Date | 2007-08-06 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
35370 | CA | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780794107 | Jack Ackerman | Internal Medicine | 227 N Jackson Ave, San Jose, CA 95116-1603 | 2006-08-30 |
| Street Address |
19059 VALLEY BLVD SUITE 103 |
| City | BLOOMINGTON |
| State | CA |
| Zip Code | 92316-2219 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811195001 | Raul A. Rodriguez Dds Inc. | Dentist | 9986 Bloomington, Bloomington, CA 92316 | 2007-07-10 |
| 1982706610 | Cathleen Helen Tapp Stewart | Dentist | 18601 Valley Boulevard, Bloomington, CA 92316 | 2006-09-02 |
| 1558840314 | Alexia Cisneros | Behavior Technician | 526 S Ironwood Ave, Bloomington, CA 92316-1218 | 2018-08-11 |
| 1295385235 | Angela Marie Sandoval | Technician | 857 S Ironwood Ave, Bloomington, CA 92316-1219 | 2019-09-11 |
| 1508348228 | Javier Sandoval Jr. | Dietitian, Registered | 516 S Linden Ave, Bloomington, CA 92316-1221 | 2018-08-29 |
| 1659746402 | Christina Kinney | Behavioral Analyst | 636 S Aspen Ave, Bloomington, CA 92316-1317 | 2015-12-04 |
| 1740634203 | Alfonso Luna IIi | Physician Assistant | 657 S Lancewood Ave, Bloomington, CA 92316-1336 | 2016-04-20 |
| 1881232650 | Sarah E Brown | Behavior Technician | 772 S Lancewood Ave, Bloomington, CA 92316-1343 | 2019-12-12 |
| 1073853255 | Alberta Frances Irons | Behavioral Analyst | 836 W Fontlee Ln, Bloomington, CA 92316-1508 | 2013-02-25 |
| 1073165650 | Genevieve Elon Monge | Family Medicine | 18651 Valley Blvd, Bloomington, CA 92316-1831 | 2019-07-12 |
| Find all providers in zip 92316 | ||||
| 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 |
|---|---|---|---|---|
| 1972162527 | Pournawattie Andrea Chandradatt | Dentist | 7936 Portland Ave S, Bloomington, MN 55420-1315 | 2019-06-07 |
| 1336601756 | Neha Shah | Dentist | 17644 Valley Blvd Ste 1, Bloomington, CA 92316-3908 | 2019-04-03 |
| 1033689054 | Erick Esmenjaud D.d.s. Inc | Dentist | 18793 Valley Blvd Ste A-b, Bloomington, CA 92316-2253 | 2018-12-03 |
| 1336620160 | Mohamed Owais Sultan | Dentist | 857 S Auto Mall Rd Ste 4, Bloomington, IN 47401-5488 | 2018-08-29 |
| 1285184259 | Children's Center for Dentistry | Dentist | 2111 E Oakland Ave Ste C, Bloomington, IL 61701-5783 | 2016-10-13 |
| 1255783320 | Fatima Quadri | Dentist | 401 N Veterans Pkwy, Unit D, Bloomington, IL 61704-3550 | 2016-07-12 |
| 1528419686 | Brandt Allen Finney | Dentist | 2909 E Buick Cadillac Blvd, Bloomington, IN 47401-5443 | 2016-06-29 |
| 1942668702 | Point Family Dentistry | Dentist | 10611 France Ave S Ste 201, Bloomington, MN 55431-3554 | 2016-02-08 |
| 1710344494 | Bloomington Smiles Dentistry, PC | Dentist | 10700 France Avenue, Suite 102, Bloomington, MN 55437 | 2016-01-26 |
| 1497160204 | Jp Dental - Bloomington, LLC | Dentist | 409 S Dunn St, Bloomington, IN 47401-4822 | 2014-07-01 |
| Find all providers in BLOOMINGTON | ||||
| City | BLOOMINGTON |
| Zip Code | 92316 |
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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.