IndividualActive
Wanda Jackson, RDH
NPI 1043323504 · Dental Hygienist · Shreveport, LA
Provider details
- NPI number
- 1043323504
- Entity type
- Individual
- Primary specialty
- Dental HygienistDental Providers
- Credential
- RDH
- Sex
- Female
- Sole proprietor
- No
- License
- 376 (LA)
Practice location
510 E Stoner Ave
#160
Shreveport, LA 71101-4243
Phone: (318) 221-8411
Fax: (318) 841-4795
Mailing address
510 E Stoner Ave
Shreveport, LA 71101-4243
Registry dates
- Enumerated
- 2006-08-17
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.