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Amirah Diane Jackson
General Practice Dentistry in Plattsburgh, New York
NPI 1821539594

Amirah Diane Jackson is a General Practice Dentistry based in Albuquerque, NY and is specialized in General Practice. Amirah Diane Jackson practices in Plattsburgh, NY. The NPI Number for Amirah Diane Jackson is 1821539594 and holds a License No. 6902 (New York).

The current practice location address for Amirah Diane Jackson is 675 State Route 3 Ste 201, Plattsburgh, NY and can be reached out via phone at 518-563-8622.

Location: 675 State Route 3 Ste 201, Plattsburgh, NY, 87131-0001
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1821539594
Provider Name
Amirah Diane Jackson
Credential
Provider Entity Type
Individual
Gender
Female
Address
675 State Route 3 Ste 201, Plattsburgh, NY, 87131-0001
Phone Number
518-563-8622
Fax Number
Provider Enumeration Date
03/15/2017
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
675 State Route 3 Ste 201
City
Plattsburgh
State
New York
Zip
12901-6501
Phone Number
518-563-8622
Fax Number
person
Provider Business Mailing Address Details
Address
675 State Route 3 Ste 201
City
Plattsburgh
State
New York
Zip
12901-6501
Phone Number
518-563-8622
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
General Practice
Taxonomy
1223G0001X
License No.
(New Mexico)
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
6902 (Louisiana)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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