MEDICARE: DR. MARIO MICHAEL JACKSON D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	4594T	NV

General Provider Information

NPI Number	:	1144302811
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARIO MICHAEL JACKSON D.D.S.

Provider Business Mailing Address
First Line	:	1013 HARP WAY
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89032-7889
Country	:	US
Telephone Number	:	702-505-3914
Fax Number	:

Provider Business Practice Location Address
First Line	:	1013 HARP WAY
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89032-7889
Country	:	US
Telephone Number	:	702-505-3914
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/20/2006
Last Update Date	:	07/08/2007

Similar Medicare Providers

1639457476 — FERNANDO HODGERS
Practice Location Address:

933 HARP WAY , #16
NORTH LAS VEGAS, NV
89032-7889

Practice Phone: 702-685-3459
Practice Fax:

1427130715 — SOUTHERN NEVADA OXYGEN, INC.
Practice Location Address:

3069 S VALLEY VIEW BLVD
LAS VEGAS, NV
89102-7889

Practice Phone: 702-696-1313
Practice Fax: 702-696-0133

1396561445 — NORMA MARTINEZ
Practice Location Address:

4660 S EASTERN AVE STE 1105390
LAS VEGAS, NV
89119-6137

Practice Phone: 702-406-9040
Practice Fax:

1073244562 — ZACHARY ALBERT COX DO
Practice Location Address:

1550 W CRAIG RD STE 220
NORTH LAS VEGAS, NV
89032-0329

Practice Phone: 702-616-5801
Practice Fax:

1558619569 — MARK SUNTAY PHARM.D
Practice Location Address:

3013 W CRAIG RD
NORTH LAS VEGAS, NV
89032-0598

Practice Phone: 702-648-6340
Practice Fax:

1609734284 — MR. ROBERT EDWARD BRABEC II
Practice Location Address:

1550 W CRAIG RD STE 310
NORTH LAS VEGAS, NV
89032-0336

Practice Phone: 702-991-1730
Practice Fax:

Directions to “ DR. MARIO MICHAEL JACKSON D.D.S.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.