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

Dr. Jacqueline Maddox

Individual provider Dentist · NPI 1497175897

Dr. Jacqueline Maddox is a Dentist in Bohemia, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2014

Practice location Address checks out

1125 Smithtown Ave
Bohemia, NY 11716-2160
Phone: (631) 589-8585
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 057987 (NY)

Record details

NPI number1497175897
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedApril 24, 2014
Last updated in NPPESAugust 30, 2021
Certification dateAugust 30, 2021
Mailing address11 43rd St, Centereach, NY 11720-2326

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