Provider Demographics
NPI:1710004403
Name:JACKSON, JENNIFER CHEEK (DMD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:CHEEK
Last Name:JACKSON
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 FARINGTON CIR
Mailing Address - Street 2:
Mailing Address - City:FLETCHER
Mailing Address - State:NC
Mailing Address - Zip Code:28732-9603
Mailing Address - Country:US
Mailing Address - Phone:919-607-1838
Mailing Address - Fax:
Practice Address - Street 1:76 PEACHTREE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-3131
Practice Address - Country:US
Practice Address - Phone:828-277-6788
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC78881223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry