Jackson Dental LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6593716-9922 Issued in UT

Legal business name

JACKSON DENTAL LLC

Practice address

1868 N 400 W Ste 110
Layton, UT 84041-2191

Phone

(801) 774-8198

Fax

(801) 774-8191

NPI assigned

May 17, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Brett R Jackson, D.M.D.NPI 1184835787

Title

Member

Phone

(801) 774-8198

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Brett Ryan Jackson, D.M.D.

  • General Practice Dentistry
  • Layton, UT
  • NPI 1184835787
  NPD (past) Authorized official
• Ron A Frost, DMD

  • General Practice Dentistry
  • Layton, UT
  • NPI 1770634594
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1305590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305590400000",
    "number": "1104119601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1868 N 400 W STE 110",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840412191",
            "telephone_number": "801-774-8198",
            "fax_number": "801-774-8191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1868 N 400 W STE 110",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840412191",
            "telephone_number": "801-774-8198",
            "fax_number": "801-774-8191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-17",
        "last_updated": "2011-05-17",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "BRETT",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "801-774-8198",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "6593716-9922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ironwood Speech Pathology LLC
• Bailey Irwin
• Jessica Irwin
• Jacob Ivan
• Christy Ivie
• Alison Jackson-Orrell
• Amanda Jackson
• Brett Ryan Jackson, D.M.D.
• Christopher Demitri Jackson
• Jeremy Jackson

• General Practice Dentistry in Layton, UT
• Providers in Layton, UT by specialty
• General Practice Dentistry in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.