Wanda Kay Jackson in Shreveport - Dental Hygienist
Wanda Kay Jackson - NPI 1043323504
Wanda Kay Jackson is a Dental Hygienist in Shreveport, Louisiana. Wanda Kay Jackson practices all healthcare services and medical treatments related to Dental Hygienist. The NPI Number for Wanda Kay Jackson is 1043323504. The last update date is 2007-07-08.
Wanda Kay Jackson's current location address is 510 E Stoner Ave, Shreveport, Louisiana. You can contact this provider via phone number 3182218411 and fax number 3188414795. The mailing address for Wanda Kay Jackson is 510 E Stoner Ave, Shreveport, Louisiana. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Wanda Kay Jackson |
|---|---|
| Address | 510 E Stoner Ave, Shreveport, Louisiana |
| Phone Number | 3182218411 |
| Fax Number | 3188414795 |
| Sole Proprietor | N |
| Credentials | RDH |
NPI Number Detail
| NPI Number | 1043323504 |
|---|---|
| Provider Enumeration Date | 2006-08-17 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 510 E Stoner Ave |
|---|---|
| City | Shreveport |
| State | Louisiana (LA) |
| Post Code | 711014243 |
| Phone Number | 3182218411 |
| Fax Number | 3188414795 |
Provider's Primary Taxonomy Detail
| Speciality | Dental Hygienist |
|---|---|
| Taxonomy | 124Q00000X |
| Licence No | 376 |
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Definition: An individual who has completed an accredited dental hygiene education program, and an individual who has been licensed by a state board of dental examiners to provide preventive care services under the supervision of a dentist. Functions that may be |
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What is the unique 10-digit identification code assigned to Wanda Kay Jackson by the Centers for Medicare & Medicaid Services?
The Wanda Kay Jackson has been issued the NPI (National Provider Identifier) 1043323504, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Where is the Wanda Kay Jackson located?
The Wanda Kay Jackson is located at 510 E Stoner Ave, Shreveport, LA 711014243.
What is Wanda Kay Jackson's specialized field of practice, and what is the corresponding taxonomy classification code?
The Wanda Kay Jackson's area of specialization is Dental Hygienist, and the corresponding taxonomy code that categorizes this field of practice is 124Q00000X.
When did the Wanda Kay Jackson receive its 1043323504?
The Wanda Kay Jackson was issued its 1043323504 on 2006-08-17, which is the date when the organization was assigned this unique identifier.
As of what date were the details pertaining to Wanda Kay Jackson last refreshed?
The information related to the Wanda Kay Jackson, including its address, specialty, and other relevant details, was last updated on 2007-07-08.
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