DR. JOSEPH C JACKSON JR. (NPI# 1801918602) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801918602 |
| Entity Type | Individual |
| Full Name | DR. JOSEPH C JACKSON JR. |
| Credential | DDS,PA |
| Practice Address |
147 2nd Ave S Ste 308 Saint Petersburg FL 33701-4393 |
| Practice Telephone | 7274156389 |
| Mailing Telephone | 7274156389 |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2020-08-11 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
DN5413 | FL | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | TAX ID | 59-2061906 | 01 |
| FL | STATE LICENSE | DN5413 | 01 |
| FL | 075453600 | 05 | |
| FL | BCBS | 85760 | 01 |
| FL | 075453601 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891152773 | Joseph Granville Jackson | Counselor | 411 Sparrow St, Lake Providence, LA 71254-3035 | 2016-01-22 |
| 1538560123 | Joseph Ryan Jackson | Chiropractor | 1043 Brownsville Rd, Morgantown, KY 42261-7011 | 2014-09-15 |
| 1922392927 | Joseph Alling Jackson | Social Worker | 66 Old Stockbridge Rd, Lenox, MA 01240-2810 | 2011-06-07 |
| 1760708127 | Joseph L Jackson | Dentist | 1241 Riverside Ave, Fort Collins, CO 80524-3204 | 2010-04-10 |
| 1962731315 | Joseph S Jackson | Counselor | 502 Downing Ct, Exton, PA 19341-2090 | 2009-12-14 |
| 1851547749 | Joseph Loy Jackson | Dentist | 2719 Limestone Pkwy, Gainesville, GA 30501-1472 | 2008-08-12 |
| 1235306143 | Joseph Jackson | Physical Therapist | 15640 S Normandie Ave, Gardena, CA 90247-4016 | 2008-05-09 |
| 1518175520 | Joseph William Jackson | Dentist | 322 N Elm St, Oxford, OH 45056-1123 | 2007-05-21 |
| 1073633624 | Joseph A Jackson | Psychiatry & Neurology | 30941 Mill Ln Ste G-132, Spanish Fort, AL 36527-5456 | 2007-03-29 |
| 1649352691 | Joseph Barry Jackson | Optometrist | 3323 Frontage Rd, Peru, IL 61354-1101 | 2006-10-19 |
| Street Address |
147 2ND AVE S STE 308 |
| City | SAINT PETERSBURG |
| State | FL |
| Zip Code | 33701-4393 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013514603 | Tien Thuy Hoang | Pharmacist | 875 Dr M.l.k. Jr St N, St. Petersburg, FL 33701 | 2020-10-06 |
| 1851920953 | Michelle Tedrowe | Student in an Organized Health Care Education/Training Program | Bayfront Health St Petersburg Family Care Center, 700 6th Street South, St. Petersburg, FL 33701 | 2020-04-02 |
| 1164070264 | Melissa Joy Fitzpatrick | Occupational Therapist | 239 14 Ave Ne, St Petersburg, FL 33701 | 2019-09-01 |
| 1841763091 | William Carpenter Scott | Dentist | 239 2nd Ave S # 100, St Petersburg, FL 33701 | 2019-01-09 |
| 1992289318 | Westminster Senior Services, Inc. | Registered Nurse | 830 North Shore Dr. Ne, St. Petersburg, FL 33701 | 2018-09-21 |
| 1265929780 | B&b Florida Eye Care Pllc | Optometrist | 1380 4th St N, St. Petersburg, FL 33701 | 2018-04-19 |
| 1730684895 | Loraine Marie Torres Garcia | Student in an Organized Health Care Education/Training Program | Bayfront Health St Petersburg, 700 6th Street South, St Petersburg, FL 33701 | 2018-03-29 |
| 1598267445 | Vincent Malik Dehili | Psychologist | 146 2nd Street North, Suite 305, St. Petersburg, FL 33701 | 2018-03-07 |
| 1770083073 | Megan Sanborn | Nurse Practitioner | 601 5th St S Ste 304, St Petersburg, FL 33701 | 2018-02-14 |
| 1174037089 | Julius Griffin | Licensed Practical Nurse | 1115 Highland St N, Apt B, Saint Petersburg, FL 33701 | 2017-11-30 |
| Find all providers in zip 33701 | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962419580 | Jerry L Stoneking D.d.s.,p.a. | Dentist | 6600 10th Ave N, Saint Petersburg, FL 33710-6104 | 2006-08-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326647215 | Matthew Inaba Pickron | Dentist | 6476 Lake Worth Rd, Lake Worth, FL 33463 | 2020-10-21 |
| 1366056848 | Brandon Lee Zipper | Dentist | 901 N Congress Ave Ste 107, Boynton Beach, FL 33426-3316 | 2020-09-02 |
| 1851903298 | Ocoee Dental & Orthodontics, P.a. | Dentist | 2910 Maguire Rd Ste 1005, Ocoee, FL 34761-4742 | 2020-08-18 |
| 1700411857 | Imagine Orthodontic Studio Pllc | Dentist | 3595 S Florida Ave, Lakeland, FL 33803-4860 | 2020-03-10 |
| 1952933541 | Katherine Kapernaros | Dentist | 1395 Center Dr Rm D7-35, Gainesville, FL 32610-3006 | 2020-02-11 |
| 1609408574 | Ortho 99 Plus 1 | Dentist | 7410 Merrill Road, Suite 2, Jacksonville, FL 32277 | 2020-02-10 |
| 1538709514 | Gardner Orthodontics | Dentist | 518 Hollyberry Lane, Suite 105, Orange Park, FL 32065 | 2020-01-08 |
| 1700421344 | Lindsay A Ringdahl Dmd Ms Pa | Dentist | 85 Weston Rd Unit 102, Weston, FL 33326-1158 | 2019-11-07 |
| 1942844493 | Daniel R Camacho | Dentist | 4330 Sheridan St Ste 201a, Hollywood, FL 33021-1406 | 2019-10-28 |
| 1982247102 | Thebis A. Franceschi | Dentist | 813 Delmar Way Apt 116, Delray Beach, FL 33483-3366 | 2019-10-21 |
| Find all providers with the same taxonomy | ||||
| City | SAINT PETERSBURG |
| Zip Code | 33701 |
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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.