DR. TRACY LESLIE JACKSON (NPI# 1740203496) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740203496 |
| Entity Type | Individual |
| Full Name | DR. TRACY LESLIE JACKSON |
| Credential | D.M.D. |
| Practice Address |
1731 Manatee Ave E Bradenton FL 34208 |
| Practice Telephone | 9417495512 |
| Practice Fax Number | 9417495826 |
| Mailing Telephone | 9417495512 |
| Mailing Fax Number | 9417495826 |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2007-07-24 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
DN0013214 | FL | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639611486 | Tracy Lynn Jackson | Behavior Technician | 412 S Central Ave, Idabel, OK 74745-6060 | 2016-11-10 |
| 1952779209 | Tracy Jackson | Nurse's Aide | 11210 Orville Ave, Cleveland, OH 44106-1327 | 2015-09-03 |
| 1982902516 | Tracy Ann Jackson | Speech-Language Pathologist | 6395 Polo Club Dr, Cumming, GA 30040-5716 | 2011-03-07 |
| 1154436590 | Tracy P Jackson | Anesthesiology | 719 Thompson Ln Ste 22209, Nashville, TN 37204-4692 | 2006-08-19 |
| 1568879732 | Tracy Jackson | Counselor | 24077 State Highway 49, Nevada City, CA 95959-8519 | 2014-07-18 |
| 1992003594 | Tracy Elaine Jackson | Pharmacist | 1000 Broad St, Sumter, SC 29150-2505 | 2011-03-05 |
| 1871894899 | Tracy I Jackson | Registered Nurse | 2209 Howard St, Evanston, IL 60202-3636 | 2010-11-08 |
| 1932334091 | Tracy Jackson | Nurse Practitioner | 1389 N Baldwin Ave, Marion, IN 46952-1913 | 2009-05-19 |
| 1295902971 | Tracy Jackson | Registered Nurse | 1487 W Keiser Ave, Osceola, AR 72370-2806 | 2008-05-13 |
| 1154461283 | Tracy Letia Jackson | Physician Assistant | 215 W 125th St, New York, NY 10027-4426 | 2007-02-07 |
| Street Address |
1731 MANATEE AVE E |
| City | BRADENTON |
| State | FL |
| Zip Code | 34208 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740880566 | Michael Gerard Kulikowski | Pharmacist | 6225 E Sr 64, Bradenton, FL 34208 | 2020-10-30 |
| 1104431964 | Genesis Carrillo | Pharmacist | 4210 E, Fl-64, Bradenton, FL 34208 | 2020-09-09 |
| 1962960146 | Elite Surgery Center, LLC | Plastic Surgery | 5301 4th Ave Circle E, Bradenton, FL 34208 | 2019-03-07 |
| 1740777101 | Chinelo Uche | Student in an Organized Health Care Education/Training Program | 206 2nd St. E, Brandenton, FL 34208 | 2018-04-20 |
| 1396240040 | Nicholas Guy Ross | Student in an Organized Health Care Education/Training Program | 206 2nd St E., Bradenton, FL 34208 | 2018-03-26 |
| 1881196566 | Pinnacle Dental, Inc | Dentist | 5220 4th Ave. Circle E., Bradenton, FL 34208 | 2018-03-08 |
| 1194240176 | Bradenton Community Acupuncture | Acupuncturist | 5245 Office Park Blvd Suite 103, Bradenton, FL 34208 | 2017-08-10 |
| 1316490147 | Loretta Michele Deloach | Counselor | 515 27th St. S., Ste. 3, Bradenton, FL 34208 | 2016-07-28 |
| 1730548934 | Elodie Chimuanya Epane Kamdem | Dentist | Bright Now Dentalst, 650, 3611 1st Street, Suiyr, Bradenton, FL 34208 | 2016-02-16 |
| 1215303920 | Lesley Ann White | Driver | 45 Palmwood, Bradenton, FL 34208 | 2015-08-17 |
| Find all providers in zip 34208 | ||||
| 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 |
|---|---|---|---|---|
| 1801405105 | Gustavo E Rodriguez Oliva | Dentist | 3122 53rd Ave E, Bradenton, FL 34203-4311 | 2020-07-23 |
| 1558903799 | Comfortable Care Dental Health Professionals, P.a. | Dentist | 5935 Lakewood Ranch Blvd, Bradenton, FL 34211-2464 | 2019-10-09 |
| 1932760543 | Yaima Alba | Dentist | 1602 State Hwy 684 W, Bradenton, FL 34207 | 2019-06-25 |
| 1023676814 | Comfortable Care Dental Health Professionals, P.a. | Dentist | 6250 State Road 70 E, Bradenton, FL 34203-9734 | 2019-06-05 |
| 1942779186 | Montiel Dental Care P. A | Dentist | 6818 14th St W, Bradenton, FL 34207-5808 | 2018-11-16 |
| 1134694359 | Comfortable Care Dental Health Professionals. P.a. | Dentist | 7385 University Pkwy, Bradenton, FL 34202-2300 | 2018-10-04 |
| 1881196566 | Pinnacle Dental, Inc | Dentist | 5220 4th Ave. Circle E., Bradenton, FL 34208 | 2018-03-08 |
| 1083144083 | Tanya Naravane | Dentist | 5215 Manatee Ave. W., Bradenton, FL 34209-3742 | 2017-06-13 |
| 1154858413 | Marshal Earnest | Dentist | 5215 Manatee Avenue West, Bradenton, FL 34209-3742 | 2017-05-17 |
| 1740633718 | Lara D. Bacchelli | Dentist | 8754 E State Road 70 Ste 8752, Bradenton, FL 34202-3720 | 2016-07-14 |
| Find all providers in BRADENTON | ||||
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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.