ALICIA RENEE JACKSON DDS
NPI 1710381256
Dentist in New York, NY

Q: What is Alicia Jackson's NPI number?

The NPI number for Alicia Jackson is 1710381256. It was assigned to this individual provider in the NPPES registry on October 13, 2014.

Q: What is Alicia Jackson's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Q: When was this NPI record last updated?

The NPPES record for Alicia Jackson was last updated on December 31, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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 October 13, 2014PECOS Enrolled

245 5TH AVE FL 3, NEW YORK, NY 10016(917) 747-6574 Get Directions Write a Review

NPPES record last updated: December 31, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 31, 2020, May 30, 2020 (2 updates tracked since 2020).

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About Alicia Renee Jackson Dds NPPES

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

ALICIA RENEE JACKSON DDS (NPI 1710381256) is an individual dentist in New York, New York, licensed in New York (057371-1) and active in the NPI registry since October 2014. She is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1710381256

Entity TypeIndividualFemale

Primary Taxonomy122300000X

Provider Legal NameALICIA RENEE JACKSONCredential: DDS

Location Address245 5TH AVE FL 3New York, NY 10016-8728

Mailing Address233 E Jericho TpkeHuntington Station, NY 11746-7307 · (631) 427-4327

Phone(917) 747-6574

Sole ProprietorNo

Enumeration DateOctober 13, 2014

Last NPPES UpdateDecember 31, 20202 updates tracked since enumeration

NPPES CertifiedDecember 31, 2020

✔ NPI 1710381256 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

License✔ Licensed in NY · 057371-1

Definition

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

245 5TH AVE FL 3, New York, NY 10016

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Secondary Practice Locations 2

Location 1233 E Jericho TpkeHuntington Station, NY 11746-7307 · Phone (631) 427-4327

Location 215 Broad St Apt 2414New York, NY 10005-1989 · Phone (646) 813-0645

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Alicia Renee Jackson Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 10016 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$102.04 typical visit price

range $65.69 – $198.19

Typical copayment $25.51 (range $16.42 – $49.54)

Most-billed visit code 99203

Established Patient

$81.44 typical visit price

range $21.20 – $160.66

Typical copayment $20.36 (range $5.30 – $40.16)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ALICIA RENEE JACKSON, DDS PC

Dentist