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DR. MATTHEW J JACKSON DMD NPI 1588647911


NPI Information

NPI: 1588647911
Provider Name: DR. MATTHEW J JACKSON, DMD
Classification: Oral & Maxillofacial Surgery - 204E00000X
Entity Type: Individual
Address:
243 CHARLES STREET
MASS EYE AND EAR INFIRMARY
BOSTON, MA
ZIP 02114
Phone: (617) 573-4306
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DR. Matthew J Jackson, DMD is an oral maxillofacial surgery in Boston, MA. The provider is oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery. DR. Matthew J Jackson, DMD NPI is 1588647911. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

243 CHARLES STREET
MASS EYE AND EAR INFIRMARY
BOSTON, MA
ZIP 02114
Phone: (617) 573-4306
Fax: (617) 659-4917

The enumeration date for this NPI number is 11/21/2005 and was last updated on 7/8/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1204E00000XOral & Maxillofacial Surgery11607MASSACHUSETTSYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1757863OTHERMASSACHUSETTSTUFTS HEALTH HMO
2X04571MEDICARE ID-TYPE UNSPECIFIEDMASSACHUSETTS
340346OTHERMASSACHUSETTSHARVARD PILGRIM HMO
4U55712MEDICARE UPIN
50264822MEDICAIDMASSACHUSETTS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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