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General NPI Number Information
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NPI Number | 1780065060
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Entity Type | Individual
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Provider Name | JESSIE DIXON II DDS
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Gender | Male
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Dates
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Enumeration Date | 06/12/2015
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Last Update Date | 10/18/2022
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Provider Practice Location Address
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Address Line | 944 21ST AVE N APT 909
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City | NASHVILLE
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State | TN
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Zip | 37208-3468
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Country | US
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Telephone | 318-573-9918
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Fax |
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Provider Business Mailing Address
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Address Line | 5602 TREECROSSING PKWY
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City | HOOVER
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State | AL
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Zip | 35244
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Country | US
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Telephone | 318-573-9918
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 6698
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 31660
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License Number State | TX
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