Stacy Marie Jackson
Dentist Pediatric Dentist
9871 S Parker Rd Unit 103
Parker
, Colorado 80134-8802
Stacy Marie Jackson
Dentist Pediatric Dentist
9871 S Parker Rd Unit 103
Parker
, Colorado 80134-8802
(785) 249-2973
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About
Features
Specialties
- Dentist
- Pediatric Dentist
Languages spoken
- English
Location
First Address
- Stacy Marie Jackson
- 8155 E Fairmount Dr Unit 2131
- Denver, CO
- Zip : 80230-6840
- Phone : (785) 249-2973
Second Address
- Stacy Marie Jackson
- 9871 S Parker Rd Unit 103
- Parker, CO
- Zip : 80134-8802
- Phone : (303) 957-3207
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 122300000X | Dentist | 2010016174 | MO |
| Y | 1223P0221X | Pediatric Dentist | DEN.00202791 | CO |
National Provider Identifier
| NPI | 1043530991 |
|---|---|
| Provider Name | Stacy Marie Jackson |
| First Address | Denver, CO 80230-6840 |
| Second Address | Parker, CO 80134-8802 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 02/06/2010 |
| Last Update Date | 25/09/2019 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.