DR. GREGORY WAYNE JACKSON (NPI# 1801970769) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801970769 |
| Entity Type | Individual |
| Full Name | DR. GREGORY WAYNE JACKSON |
| Credential | DDS |
| Practice Address |
6435 S Pulaski Rd Chicago IL 60629-5148 |
| Practice Telephone | 7737670849 |
| Practice Fax Number | 7737670861 |
| Mailing Telephone | 7737670849 |
| Mailing Fax Number | 7737670861 |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2007-07-08 |
| 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 |
IL | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295194124 | Gregory L Jackson | Social Worker | 342 W Progress Rd, Prentiss, MS 39474-5221 | 2016-02-20 |
| 1811170293 | Gregory Emory Jackson | Pharmacist | 526 W 30th Street, Ny, NY 10001 | 2007-12-09 |
| 1184738825 | Gregory Mann Jackson | Specialist | 4220 Mccullough Ave, San Antonio, TX 78212-1910 | 2006-08-19 |
| 1134158009 | Gregory Alan Jackson | Physical Therapist | 5501 Swift Rd, Sarasota, FL 34231-6209 | 2006-07-02 |
| 1982640090 | Gregory R Jackson | Radiology | 800 Mercy Hospital, Alegent Mercy Hospital, Council Bluffs, IA 51503 | 2006-06-20 |
| 1356306203 | Gregory Lee Jackson | Specialist/Technologist | 3821 Everetts Dl, Lexington, KY 40514-1185 | 2006-04-20 |
| 1568092088 | Gregory Christopher Jackson | Psychologist | 4141 Geary Blvd, San Francisco, CA 94118-3109 | 2020-01-23 |
| 1346747110 | Gregory Jackson | Student in an Organized Health Care Education/Training Program | 1161 21st Ave S, Nashville, TN 37232-0004 | 2018-04-09 |
| 1285167304 | Gregory M. Jackson II | Nurse Practitioner | 8600 Wurzbach Rd, Suite 1110, San Antonio, TX 78240-4330 | 2017-04-05 |
| 1942651708 | Gregory Jackson | Physical Therapy Assistant | 9685 Chillicothe Rd, Kirtland, OH 44094-8503 | 2016-06-23 |
| Street Address |
6435 S PULASKI RD |
| City | CHICAGO |
| State | IL |
| Zip Code | 60629-5148 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073822490 | Jack S. Litz, D.d.s., Ltd. | Dentist | 6435 S Pulaski Rd, Chicago, IL 60629-5148 | 2010-10-04 |
| 1013044825 | Gregory John Dalton | Dentist | 6435 S Pulaski Rd, Chicago, IL 60629-5148 | 2007-02-28 |
| 1205911120 | Gregory W. Jackson Dds, Ltd | Clinic/Center | 6435 S Pulaski Rd, Chicago, IL 60629-5148 | 2006-10-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053946392 | T & M Care LLC | In Home Supportive Care | 7230 S Talman, Apt 4, Chicago, IL 60629 | 2020-03-06 |
| 1841847811 | Jacqueline Ann Milton | Technician | 6720 South Keating, Chicago, IL 60629 | 2019-08-23 |
| 1194202085 | Andrea Mosqueda | Counselor | 4217 W 59th St, Chicago, IL 60629 | 2018-07-23 |
| 1316439235 | Saliha Awais | Dentist | 5521 S. Kedzie Ave. Suite 105, Chicago, IL 60629 | 2018-06-06 |
| 1356833255 | Irfana Ilyas | Dentist | 2403,5521 S Kedzie Ave, Suite 105, Chicago, IL 60629 | 2018-06-06 |
| 1427547538 | Holy Cross Hospital | Psychiatric Unit | 2701 West 68th Street, Chicago, IL 60629 | 2018-05-03 |
| 1871003715 | Siddhi Vinayak Dental | Clinic/Center | 5521 S Kedzie Ave, Unit 105, Chicago, IL 60629 | 2017-10-05 |
| 1477092328 | Debra Shepard | Social Worker | 2601 W. Marquette Rd., Catholic Charities, Chicago, IL 60629 | 2017-02-13 |
| 1255777108 | Jacquelyn Jones | Developmental Therapist | 3108 West Marquette Road Apartment 1-b, Chicago, IL 60629 | 2013-05-20 |
| 1124368030 | Claudia Ballesteros | Interpreter | 5631 S. Richmond, Chicago, IL 60629 | 2013-03-01 |
| Find all providers in zip 60629 | ||||
| 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 |
|---|---|---|---|---|
| 1427670421 | Braces By Barnes | Dentist | 1335 E 87th St Ste B, Chicago, IL 60619-7036 | 2020-05-12 |
| 1922645308 | Riddhi J Desai Dmd Pllc | Dentist | 727 W Madison St Apt 1208, Chicago, IL 60661-2409 | 2019-12-04 |
| 1346806577 | Pulaski Smiling Dental P.C. | Dentist | 5540 S Pulaski Rd Fl 1, Chicago, IL 60629-4418 | 2019-05-13 |
| 1750944252 | Candid Illinois, Pllc | Dentist | 750 N Franklin St Fl Stc2, Chicago, IL 60654-6263 | 2019-04-19 |
| 1407314610 | Orthodontic Experts Ltd | Dentist | 3339 W Belmont Ave, Chicago, IL 60618-5518 | 2019-03-06 |
| 1669938387 | Theresa Karras | Dentist | 11 E Cedar St, Floor 2, Chicago, IL 60611-6066 | 2019-02-19 |
| 1396235651 | Love My Smile Chicago, LLC | Dentist | 2112 N Clybourn Ave Unit B, Chicago, IL 60614-0800 | 2018-05-12 |
| 1013414655 | Flavio Jose Castelli Sanchez | Dentist | 801 S Paulina St Rm 131, Chicago, IL 60612-7210 | 2018-04-10 |
| 1437659570 | John C Ford | Dentist | 225 E Chicago Ave # 75, Chicago, IL 60611-2991 | 2018-02-15 |
| 1437657582 | Orthodontic Experts | Dentist | 1654 W North Ave, Chicago, IL 60622-2255 | 2018-01-24 |
| Find all providers in CHICAGO | ||||
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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.