Jackson, Dainty J
Jackson, Dainty J is an sole proprietor health care provider with primary practice located at 11315 Pembrooke Sq Ste 112 , Waldorf MD 20603-4806. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Jackson, Dainty J can be contacted via phone (301) 885-3350.Contact Information
Primary practice address
11315 Pembrooke Sq Ste 112
Waldorf MD 20603-4806
Phone: (301) 885-3350
Fax: (240) 222-3899
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | H0058218 | Maryland |
Profile Details
| NPI number | 1194765834 |
|---|---|
| LBN Legal business name | Jackson, Dainty J |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 8th, 2006 |
| Last updated | Feb 8th, 2019 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1194765834 | NPPES |
| Maryland | MEDICAID | 401725102 |
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