DR. MATTHEW DV JACKSON (NPI# 1962481887) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962481887 |
| Entity Type | Individual |
| Full Name | DR. MATTHEW DV JACKSON |
| Credential | DDS |
| Practice Address |
9319 E Harry #126 Wichita KS 67207 |
| Practice Telephone | 3166837081 |
| Practice Fax Number | 3166838149 |
| Mailing Telephone | 3166837081 |
| Mailing Fax Number | 3166838149 |
| Enumeration Date | 2006-01-10 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
KS7131 | KS | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KS | BCBS OF KS | 059792 | 01 |
| UNITED CONCORDIA | 976141 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184278913 | Matthew Jackson | Student in an Organized Health Care Education/Training Program | 540 W 5150 S, Washington Terrace, UT 84405-6530 | 2019-07-30 |
| 1922651041 | Matthew Jackson | Social Worker | 1820 Pleasant Dr, Portage, MI 49002-5604 | 2019-07-17 |
| 1093289795 | Matthew Kory Jackson | Chiropractor | 515 E 4500 S Ste G230, Salt Lake City, UT 84107-4510 | 2019-01-15 |
| 1932558210 | Matthew Jackson | Driver | 3121 Johnston St Apt 142, Lafayette, LA 70503-3760 | 2016-06-08 |
| 1306237201 | Matthew Jackson | Specialist/Technologist | 51 Edward Rd, Townsend, MA 01469-1107 | 2015-02-12 |
| 1710235452 | Matthew Kane Jackson | Pharmacist | 942 Loy Cemetery Rd, Columbia, KY 42728-8719 | 2012-08-28 |
| 1619103702 | Matthew Matthew Jackson | Case Manager/Care Coordinator | 1101 West Morgan St, Suite 8, Paragould, AR 72450-3949 | 2009-06-03 |
| 1609942531 | Matthew Bryan Jackson | Massage Therapist | 2600 Sw Barton Street, Suite A24, Seattle, WA 98126 | 2006-11-24 |
| 1528590460 | Matthew Dean Jackson | Student in an Organized Health Care Education/Training Program | 571 S Floyd St, Ste 412, Louisville, KY 40202-3818 | 2017-03-30 |
| 1699128645 | Matthew Jackson | Orthopaedic Surgery | 27351 Dequindre Rd, Madison Heights, MI 48071-3487 | 2016-07-14 |
| Street Address |
9319 E HARRY #126 |
| City | WICHITA |
| State | KS |
| Zip Code | 67207 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225527518 | Transition Adult Home | Day Training, Developmentally Disabled Services | 7422 E Lincoln St, Wichita, KS 67207 | 2018-05-02 |
| 1558734012 | Sonnya Natria Adams | Point of Service | 8722 Longlake Circle, Wichita, KS 67207 | 2015-11-05 |
| 1245623677 | Costco Wholesale Corporation | Pharmacy | 9700 E. Kellogg, Wichita, KS 67207 | 2015-03-10 |
| 1528468105 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 9415 East Harry Street, Bldg 800, Suite P, Wichita, KS 67207 | 2014-09-02 |
| 1962819110 | Lauren Carrillo | Marriage & Family Therapist | 111 S Whittier St Ste 1500, Wichita, KS 67207 | 2014-07-21 |
| 1962827170 | Providence Home Health & Hospice LLC. | Home Health | 9415 E Harry St Ste 703, Wichita, KS 67207 | 2014-02-25 |
| 1396089892 | Christina Rhinesmith | Speech-Language Pathologist | 12618 E Willowgreen Circle, Wichita, KS 67207 | 2012-11-21 |
| 1528360047 | Compassionate Care Home Health Agency | Home Health | 9152 Funston Ct., Wichita, KS 67207 | 2010-12-04 |
| 1477769503 | Patricia Marie Sloop | Social Worker | 1950 S. Webb Rd., Unit #121, Wichita, KS 67207 | 2007-05-15 |
| 1174738298 | Jarrod S Steffan | Psychologist | 9920 East Harry, Wichita, KS 67207 | 2007-05-11 |
| Find all providers in zip 67207 | ||||
| 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 |
|---|---|---|---|---|
| 1417435330 | Joseph P Houlik, Dds, LLC | Dentist | 2759 N Tyler Rd, Wichita, KS 67205-8711 | 2018-08-02 |
| 1982199790 | Ashton N Pargman | Dentist | 8150 E Douglas Ave Ste 10, Wichita, KS 67206-2362 | 2018-06-25 |
| 1801330980 | Smile Connections Family Dental, L.L.C. | Dentist | 250 N Tyler Rd, Wichita, KS 67212-3753 | 2016-12-08 |
| 1295286474 | Davis & Dold Dental, LLC | Dentist | 7570 W 21st St N Ste 1050b, Wichita, KS 67205-1772 | 2016-10-21 |
| 1194173955 | Kati Irene Beam | Dentist | 2222 N Greenwich Rd Ste 400, Wichita, KS 67226-8252 | 2016-06-01 |
| 1942662580 | Eric S. Farmer, Dds, P.a. | Dentist | 7520 W Village Cir, Wichita, KS 67205-9362 | 2016-03-23 |
| 1528424702 | Parklane Dental Pa | Dentist | 980 S Oliver St, Wichita, KS 97218-3216 | 2016-01-04 |
| 1053659508 | Nguyen Dmd Pa | Dentist | 9415 E Harry St Ste 606, Wichita, KS 67207-5082 | 2013-01-17 |
| 1083992655 | Kristyn Leanne Barker | Dentist | 2046 N Oliver Ave, Wichita, KS 67208-2503 | 2011-07-29 |
| 1336427582 | Wichita State University | Dentist | 2838 N. Oliver, Wichita, KS 67220-0157 | 2011-07-21 |
| Find all providers in WICHITA | ||||
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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.