Richard Fredrick Jackson in Roseville - Oral And Maxillofacial Surgery
Richard Fredrick Jackson - NPI 1124116066
Richard Fredrick Jackson is a Oral And Maxillofacial Surgery in Roseville, California. Richard Fredrick Jackson practices all healthcare services and medical treatments related to Oral And Maxillofacial Surgery. The NPI Number for Richard Fredrick Jackson is 1124116066. The last update date is 2015-06-05.
Richard Fredrick Jackson's current location address is 1441 Secret Ravine Pkwy, Roseville, California. You can contact this provider via phone number 9167871515 and fax number 9167871516. The mailing address for Richard Fredrick Jackson is 1441 Secret Ravine Pkwy, Roseville, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Richard Fredrick Jackson |
|---|---|
| Address | 1441 Secret Ravine Pkwy, Roseville, California |
| Phone Number | 9167871515 |
| Fax Number | 9167871516 |
| Sole Proprietor | Y |
| Credentials | DD.S. |
NPI Number Detail
| NPI Number | 1124116066 |
|---|---|
| Provider Enumeration Date | 2006-10-10 |
| Last Updated Date | 2015-06-05 |
Provider Mailing Address Detail
| Address | 1441 Secret Ravine Pkwy |
|---|---|
| City | Roseville |
| State | California (CA) |
| Post Code | 956616044 |
| Phone Number | 9167871515 |
| Fax Number | 9167871516 |
Provider's Primary Taxonomy Detail
| Speciality | Oral And Maxillofacial Surgery |
|---|---|
| Taxonomy | 1223S0112X |
| Licence No | 24465 |
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Definition: The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
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What is the unique 10-digit identifier code issued to Richard Fredrick Jackson by the Centers for Medicare & Medicaid Services?
The Richard Fredrick Jackson has been assigned the NPI (National Provider Identifier) 1124116066 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Where is the Richard Fredrick Jackson located?
The Richard Fredrick Jackson is located at 1441 Secret Ravine Pkwy, Roseville, CA 956616044.
What is Richard Fredrick Jackson's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Richard Fredrick Jackson is Oral And Maxillofacial Surgery, and the taxonomy code that categorizes this field of expertise is 1223S0112X.
On what date did the Richard Fredrick Jackson receive its 1124116066 assignment from the Centers for Medicare & Medicaid Services?
The Richard Fredrick Jackson was assigned its 1124116066 by the Centers for Medicare & Medicaid Services on 2006-10-10.
When was the information regarding Richard Fredrick Jackson most recently updated?
The details pertaining to the Richard Fredrick Jackson, including its address, specialty, and other relevant information, were last refreshed on 2015-06-05.
NPI Number: 1336142389
Address: Po Box 2004, East Syracuse, NY