DEZJUAN VONTE JACKSON
NPI 1679073183
Prosthetic/Orthotic Supplier in Oklahoma City, OK

Q: What is Dezjuan Jackson's NPI number?

The NPI number for Dezjuan Jackson is 1679073183. It was assigned to this individual provider in the NPPES registry on February 20, 2018.

Q: What is Dezjuan Jackson's specialty?

The primary specialty registered for this NPI is Prosthetic/Orthotic Supplier with taxonomy code 335E00000X.

Q: When was this NPI record last updated?

The NPPES record for Dezjuan Jackson was last updated on February 20, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since February 20, 2018

10461 N MAY AVE, OKLAHOMA CITY, OK 73120(405) 543-6314 Get Directions Write a Review

NPPES record last updated: February 20, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dezjuan Vonte Jackson NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DEZJUAN VONTE JACKSON (NPI 1679073183) is an individual prosthetic/orthotic supplier provider in Oklahoma City, Oklahoma, licensed in Oklahoma (314007) and active in the NPI registry since February 2018.

NPPES Registry Identity

NPI1679073183

Entity TypeIndividualMale

Primary Taxonomy335E00000X

Provider Legal NameDEZJUAN VONTE JACKSON

Location Address10461 N MAY AVEOklahoma City, OK 73120-2610

Mailing Address10461 N May AveOklahoma City, OK 73120-2610 · (405) 543-6314

Phone(405) 543-6314

Sole ProprietorYes

Enumeration DateFebruary 20, 2018

✔ NPI 1679073183 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyProsthetic/Orthotic SupplierSuppliers

Taxonomy Code335E00000X

License✔ Licensed in OK · 314007

Definition

An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition.

Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X

10461 N MAY AVE, Oklahoma City, OK 73120

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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Dezjuan Jackson's NPI number?

The NPI number for Dezjuan Jackson is 1679073183. It was assigned to this individual provider in the NPPES registry on February 20, 2018.

Where is Dezjuan Jackson located?

Dezjuan Jackson practices at 10461 N May Ave, Oklahoma City, OK 73120. The listed phone number is (405) 543-6314.

What is Dezjuan Jackson's specialty?

The primary specialty registered for this NPI is Prosthetic/Orthotic Supplier with taxonomy code 335E00000X.

When was this NPI record last updated?

The NPPES record for Dezjuan Jackson was last updated on February 20, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.