Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Brandon Joshua Jackson, DDS

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1861753949

Dr. Brandon Joshua Jackson, DDS is a Student in an Organized Health Care Education/Training Program in Staten Island, New York. Licensed in New York. Registered with an NPI since 2012.

Licensed in
NY
In the registry since
2012
Specialties on file
3
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.

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Practice location Address checks out

70 Virginia Ave
Staten Island, NY 10305-1748
Phone: (718) 226-8851
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Dentistry (primary) Taxonomy 1223P0221X · Licence 056966-1 (NY)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X (NY)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1861753949
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS
Sole proprietorNo
NPI enumeratedJune 5, 2012
Last updated in NPPESSeptember 15, 2015

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