Velasco, Ignacio
Velasco, Ignacio is an sole proprietor health care provider with primary practice located at 2500 N State St , Jackson MS 39216-4500. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Velasco, Ignacio can be contacted via phone (601) 984-6090.Contact Information
Primary practice address
2500 N State St
Jackson MS 39216-4500
Phone: (601) 984-6090
Fax: (601) 984-4949
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | 15341809-8 | Zz |
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | OS-538-17 | Mississippi |
Profile Details
| NPI number | 1780083311 |
|---|---|
| LBN Legal business name | Velasco, Ignacio |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 20th, 2014 |
| Last updated | Jan 31st, 2019 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1780083311 | NPPES |
| Mississippi | MEDICAID | 08437071 |
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