Provider Demographics
NPI:1780914952
Name:JEANPIERRE, DICKENSON (DC)
Entity type:Individual
Prefix:
First Name:DICKENSON
Middle Name:
Last Name:JEANPIERRE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:361 NE 180TH DR
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33162-1768
Mailing Address - Country:US
Mailing Address - Phone:305-450-7015
Mailing Address - Fax:
Practice Address - Street 1:4330 SHERIDAN ST STE 201B
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-1406
Practice Address - Country:US
Practice Address - Phone:954-589-0010
Practice Address - Fax:954-589-0698
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-11
Last Update Date:2011-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9867111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor