Provider Demographics
NPI:1982124095
Name:JACKSON, VALENCIA DENEASE BARNES (DDS)
Entity type:Individual
Prefix:DR
First Name:VALENCIA
Middle Name:DENEASE BARNES
Last Name:JACKSON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:VALENCIA
Other - Middle Name:DENEASE
Other - Last Name:BARNES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:201 18TH ST S UNIT 101
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35233-1875
Mailing Address - Country:US
Mailing Address - Phone:205-701-4256
Mailing Address - Fax:205-973-9966
Practice Address - Street 1:201 18TH ST S UNIT 101
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-1875
Practice Address - Country:US
Practice Address - Phone:205-701-4256
Practice Address - Fax:205-973-9966
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-21
Last Update Date:2025-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALD.0006845122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist