BRUCE A. JACKSON II, DDS, PLC (NPI# 1639783137) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639783137 |
| Entity Type | Organization |
| Organization Name | BRUCE A. JACKSON II, DDS, PLC |
| Practice Address |
4829 E Beltline Ave Ne Grand Rapids MI 49525-9747 |
| Practice Telephone | 6163638707 |
| Mailing Telephone | 6163638707 |
| Enumeration Date | 2020-09-02 |
| Last Update Date | 2020-09-02 |
| Authorized Official Name | DR. BRUCE JACKSON II (OWNER) |
| Authorized Official Telephone | 6163638707 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
| Street Address |
4829 E BELTLINE AVE NE |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49525-9747 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457333098 | Kristie Sue Buchholz | Nurse Practitioner | 4829 E Beltline Ave Ne, Grand Rapids, MI 49525-9747 | 2005-11-18 |
| 1033730213 | Rhett Baylor Jackson | Dentist | 4829 E Beltline Ave Ne, Grand Rapids, MI 49525-9747 | 2020-04-29 |
| 1831727585 | Rockford Speech Therapy | Speech-Language Pathologist | 4829 E Beltline Ave Ne, Grand Rapids, MI 49525-9747 | 2020-03-30 |
| 1205396538 | Susan Missad Counseling | Psychologist | 4829 E Beltline Ave Ne, Grand Rapids, MI 49525-9747 | 2019-03-22 |
| 1861971145 | Maria Herrala | Social Worker | 4829 E Beltline Ave Ne, Grand Rapids, MI 49525-9747 | 2018-08-08 |
| 1649729286 | Lynnae Dawn Guffie | Social Worker | 4829 E Beltline Ave Ne, Grand Rapids, MI 49525-9747 | 2016-09-23 |
| 1194182469 | Jonathan Mulder | Counselor | 4829 E Beltline Ave Ne, Suite 103, Grand Rapids, MI 49525-9747 | 2016-01-18 |
| 1184019077 | Cognitive Therapy of Grand Rapids | Psychologist | 4829 E Beltline Ave Ne, Bldg 1 Suite 100, Grand Rapids, MI 49525-9747 | 2015-03-30 |
| 1871912709 | Angela Schmidt | Psychologist | 4829 E Beltline Ave Ne, Building 1, Suite 100, Grand Rapids, MI 49525-9747 | 2014-04-08 |
| 1700207727 | Keystone Chiropractic Plc | Chiropractor | 4829 E Beltline Ave Ne, Suite 304, Grand Rapids, MI 49525-9747 | 2013-12-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053928507 | Therapy With Nicole Pllc | Community/Behavioral Health | 4867 E. Beltline Ave. Ne, Building #1 Lower Level, Grand Rapids, MI 49525 | 2020-09-29 |
| 1184242760 | Christian Healthcare Specialists, Inc. | Obstetrics & Gynecology | 3322 Beltline Court Ne, Suite 1, Grand Rapids, MI 49525 | 2020-07-09 |
| 1174154645 | Amy Vanderslik | Case Manager/Care Coordinator | 3310 Eaglecrest Park Dr. Ne, Suite 100, Grand Rapids, MI 49525 | 2020-02-03 |
| 1477195246 | Epic Discoveries LLC | Counselor | 4867 E. Beltline Ave Ne, Grand Rapids, MI 49525 | 2019-10-14 |
| 1598228959 | Kim Scherencel Lmsw Counseling | Social Worker | 3280 Beltline Ne, Grand Rapids, MI 49525 | 2019-04-11 |
| 1821558958 | Mindful Trajectories | Social Worker | 3280 Beltlne Ct Ne, Grand Rapids, MI 49525 | 2019-03-24 |
| 1104380518 | Julianne Lettinga, Ma Lpc Counseling | Counselor | 3280 East Beltline Ct Ne, Grand Rapids, MI 49525 | 2019-01-30 |
| 1396227229 | Christopher Scot Doucette | Social Worker | 2064 Airway St Ne, Grand Rapids, MI 49525 | 2018-09-06 |
| 1568976017 | Amy K. Deyoung, Dds, Ms, PC Pediatric Dentistry | Dentist | 3297 Eagle Run Dr. Ne, Grand Rapids, MI 49525 | 2017-11-20 |
| 1407389604 | Kelly Jo Crabb | Social Worker | 4829 E Beltline Ave Ne Ste 100, Grand Rapids, MI 49525 | 2017-04-05 |
| Find all providers in zip 49525 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235739533 | Randy J Breen Dds Pllc | Clinic/Center | 2460 Burton St Se Ste 201, Grand Rapids, MI 49546-4800 | 2020-10-27 |
| 1720685399 | Elias Dental Lab | Clinic/Center | 535 Greenwood Ave Se Ste 100, Grand Rapids, MI 49506-2901 | 2020-10-06 |
| 1780291815 | Met & Associates, Plc | Clinic/Center | 2140b Wealthy St Se, Grand Rapids, MI 49506-3032 | 2020-09-23 |
| 1568075786 | D & J Dental Holdings Pllc | Clinic/Center | 2249 Wealthy St Se Ste 100, Grand Rapids, MI 49506-3055 | 2020-08-27 |
| 1023627163 | Grand Ridge Family Dentistry | Clinic/Center | 3350 Grand Ridge Dr Ne, Grand Rapids, MI 49525-7071 | 2020-07-24 |
| 1679062772 | Smile Cascade, P.C. | Clinic/Center | 4505 Cascade Rd Se # A, Grand Rapids, MI 49546 | 2018-05-03 |
| 1801060702 | Randall W. Chambers, Dds, PC | Clinic/Center | 6143 28th St Se, Grand Rapids, MI 49546-6941 | 2008-04-22 |
| 1194855155 | County of Kent | Clinic/Center | 700 Fuller Ave Ne, Grand Rapids, MI 49503-1918 | 2007-03-07 |
| 1114524881 | Joshua Palmateer Dmd and Katelyn Palmateer Dmd, Pllc | Clinic/Center | 4701 Plainfield Ave Ne, Grand Rapids, MI 49525-1644 | 2020-10-06 |
| 1699380584 | Vander Linde Family and Cosmetic Dentistry | Clinic/Center | 2609 Breton Rd Se, Grand Rapids, MI 49546-5631 | 2020-09-09 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 49525 |
Please comment or provide details below to improve the information on BRUCE A. JACKSON II, DDS, PLC.
| 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.