HENRY JACKSON (NPI# 1871147116) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871147116 |
| Entity Type | Individual |
| Full Name | HENRY JACKSON |
| Credential | DMD |
| Practice Address |
55 Glenda Trce Newnan GA 30265-3887 |
| Mailing Address |
106 W Cove Dr Newnan GA 30263-6370 |
| Practice Telephone | 7702524466 |
| Mailing Telephone | 6788775423 |
| Enumeration Date | 2019-07-25 |
| Last Update Date | 2019-07-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
DN015907 | GA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | GENERAL PRACTICE | DN015907 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699213959 | Henry Lee Jackson Jr. | Dentist | 334 E Hanes Mill Rd, Winston Salem, NC 27105-9135 | 2017-02-07 |
| 1124441621 | Henry Edward Jackson | Kinesiotherapist | 1703 Georgia Ave, Richmond, VA 23220 | 2014-02-04 |
| 1063667053 | Henry Jackson | Physical Therapist | 5605 Tilden Ave, Brooklyn, NY 11203-4819 | 2008-11-18 |
| 1497953368 | Henry Benson Jackson | Social Worker | 10 Peterboro Det. Central City Community Mental Health, Detroit, MI 48201-2722 | 2007-07-03 |
| 1871610899 | Henry Clarke Jackson Jr. | Specialist/Technologist | 1119 Veterans Dr, Florence, AL 35630-4951 | 2007-03-23 |
| 1679549836 | Henry A Jackson | Internal Medicine | 4224 Houma Blvd Ste 380, Metairie, LA 70006-2980 | 2006-02-27 |
| 1568833606 | Henry Jackson | Social Worker | 1500 Waters Pl, Bronx, NY 10461-2723 | 2015-10-15 |
| 1558624866 | Henry Carson Jackson | Family Medicine | 10497 Town and Country Way, Suite 360, Houston, TX 77024-1117 | 2012-06-21 |
| 1811280902 | Henry Jackson | Case Manager/Care Coordinator | 620 S Laurel St, Pine Bluff, AR 71601-4859 | 2011-05-23 |
| 1285643452 | Henry Jackson | Internal Medicine | 1 Freedom Way, Vamc-augusta-ud (26), Augusta, GA 30904-6258 | 2006-08-05 |
| Street Address |
55 GLENDA TRCE |
| City | NEWNAN |
| State | GA |
| Zip Code | 30265-3887 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265041537 | Shiva Bazargan | Pharmacist | 3116 Sr 34 West, Newnan, GA 30265 | 2020-07-23 |
| 1992322549 | Doctorsbeyond Inc. | Clinic/Center | 277 Skyview Court, Newnan, GA 30265 | 2020-06-30 |
| 1225652936 | Jerrica Conyers | Nurse Practitioner | 1635 Highwat 34 East Suite C, Newnan, GA 30265 | 2020-05-29 |
| 1982234688 | Morgan Elizabeth Bross | Physician Assistant | 1825 Ga- 34, Newnan, GA 30265 | 2020-01-22 |
| 1013553379 | Hopebridge LLC | Behavior Technician | 2147 Newnan Crossing Boulevard East, Newnan, GA 30265 | 2019-11-21 |
| 1518528116 | Stepping Stones Psychiatric Care LLC | Nurse Practitioner | 3025 Sharpsburg Mccullum Rd, Building B Suite 103, Newnan, GA 30265 | 2019-06-25 |
| 1356823363 | Stephen William Jacon | Specialist/Technologist | 29 Muirfield Court, Newnan, GA 30265 | 2018-09-05 |
| 1881176832 | Blueprint Psychiatry, LLC | Psychiatry & Neurology | 1601 Highway 34 E Ste A, Newnan, GA 30265 | 2018-09-05 |
| 1548790769 | Timothy Collins | Physical Therapist | 1755 Ga-34, Suite 1300, Rehab Department, Newnan, GA 30265 | 2017-06-20 |
| 1497289748 | Edible Health & Wellness,llc | Clinic/Center | 90f Glenda Trace Pmb 318, Newnan, GA 30265 | 2017-04-13 |
| Find all providers in zip 30265 | ||||
| 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 |
|---|---|---|---|---|
| 1306452016 | Georgia Dental Professionals, PC | Dentist | 2680 Highway 34 E Ste A, Newnan, GA 30265-1330 | 2020-09-17 |
| 1235762188 | Stiehl Family Dentistry, LLC | Dentist | 55 Glenda Trce # 338, Newnan, GA 30265-3887 | 2020-02-19 |
| 1164064481 | Coweta Dentistry Sda PC | Dentist | 203 Millard Farmer Ind Blvd, Newnan, GA 30263-1012 | 2019-10-09 |
| 1669924031 | Vsm Aberdeen Dental LLC | Dentist | 71 Postal Pkwy, Newnan, GA 30263-2979 | 2016-11-01 |
| 1700248085 | Komal Bhat | Dentist | 1741 Newnan Crossing Blvd E Ste M, Newnan, GA 30265-6600 | 2016-03-24 |
| 1457739971 | Kanu Priya Goel | Dentist | 201 Newnan Crossing Bypass, Newnan, GA 30263-2401 | 2015-05-16 |
| 1588906572 | Moataz N Elkasrawy | Dentist | 201 Newnan Crossing Byp, Newnan, GA 30265-1063 | 2013-03-18 |
| 1316105240 | Daniel Brent Mcmanus | Dentist | 7 Baynard Park, Newnan, GA 30265 | 2008-05-28 |
| 1356514251 | Patrick H Yancey IIi Dmd | Dentist | 119 Jackson Street, Newnan, GA 30263 | 2008-04-11 |
| 1124298104 | Afi Wilkins | Dentist | 1741 Newnan Crossing Boulevard, Suite I, Newnan, GA 30265 | 2008-03-06 |
| Find all providers in NEWNAN | ||||
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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.