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
Fax: (240) 222-3899
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1194765834 NPPES
Maryland MEDICAID 401725102

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