State Street-Orthodontics LLC
NPI 1912852682ActiveOrganization· Dentist, Orthodontics and Dentofacial Orthopedics· Hackensack, NJ
Dentist, Orthodontics and Dentofacial Orthopedics in Hackensack, New Jersey, registered in NPPES in February 2026. The authorized official on file is Edward Michael Jackson, DMD, Owner.
Overview
| NPI | 1912852682 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Feb 27, 2026 |
| Last updated in NPPES | Feb 27, 2026 |
| Certified by provider | Feb 27, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, Orthodontics and Dentofacial Orthopedics Primary | 1223X0400X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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