Jackson, Janice Gibson
Jackson, Janice Gibson is an sole proprietor health care provider with primary practice located at 1600 7Th Ave S , Birmingham AL 35233-1711. She recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as her primary health care specialty. Jackson, Janice Gibson can be contacted via phone (205) 939-5174.Contact Information
Primary practice address
1600 7Th Ave S
Birmingham AL 35233-1711
Phone: (205) 939-5174
Fax: (205) 939-9796
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Pediatric Dentistry | 1223P0221X | 3255 | Alabama |
Profile Details
| NPI number | 1174699946 |
|---|---|
| LBN Legal business name | Jackson, Janice Gibson |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 25th, 2006 |
| Last updated | Oct 5th, 2018 - about 8 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 | 1174699946 | NPPES |
| Alabama | MEDICAID | 219143 | |
| Alabama | MEDICAID | 009935520 | |
| Alabama | MEDICAID | 009936105 | |
| Alabama | MEDICAID | 009962890 |
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