Andrea Denise Jackson, DDS, MS

Prosthodontics · Clinton, MD

Individual Active NPI

NPI number 1578707204

Practice location

6912 Wade Ave
Clinton, MD 20735-2743
Phone
(301) 868-3317

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NPI record

NPI
1578707204
Entity type
Individual (Type 1)
Enumeration date
April 24, 2009
Last updated
April 24, 2009
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Prosthodontics Primary 1223P0700X DN4077 DC
Prosthodontics 1223P0700X 08111 MD

About Dr. Jackson

Andrea Denise Jackson, DDS, MS is a healthcare provider registered in the NPI registry with the primary taxonomy Prosthodontics (code 1223P0700X). The practice location is 6912 Wade Ave, Clinton, MD 20735-2743. The NPI number 1578707204 was assigned on April 24, 2009 and the record was last updated on April 24, 2009.

Dr. Jackson lists 2 licenses in the registry: #DN4077 (DC) for Prosthodontics; #08111 (MD) for Prosthodontics. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Andrea Denise Jackson, DDS, MS?

The NPI number is 1578707204.

What is the phone number of Dr. Jackson?

The phone number listed for the practice location is (301) 868-3317.

Where is Dr. Jackson located?

6912 Wade Ave, Clinton, MD 20735-2743.

What is the taxonomy code for Dr. Jackson?

The primary taxonomy code is 1223P0700X – Prosthodontics; 1 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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