Beavercreek Oh - Kyle Jackson DDS Inc

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

BEAVERCREEK OH - KYLE JACKSON DDS INC

Practice address

4090 Indian Ripple Rd Ste 102
Dayton, OH 45440-3292

Phone

(937) 986-1886

NPI assigned

Feb 16, 2026

Organization subpart

No

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

Authorized official

Name

Christina Carlson

Title

Cfo

Phone

(720) 603-4800

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1771200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784851200000",
    "number": "1184577660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4090 INDIAN RIPPLE RD STE 102",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454403292",
            "telephone_number": "937-986-1886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4090 INDIAN RIPPLE RD STE 102",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454403292",
            "telephone_number": "937-986-1886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAVERCREEK OH - KYLE JACKSON DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-02-16",
        "last_updated": "2026-07-24",
        "certification_date": "2026-07-24",
        "status": "A",
        "authorized_official_last_name": "CARLSON",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "720-603-4800"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Beaujean, PA
• Charlene Lee Beaulieu, RN
• Ronald Allan Beaulieu, MD
• Donna Lee Beaven, NP
• Barbara Beaver
• Emma Beavers, LSW
• Terian Beavers
• Michelle Bechler, DO
• Angela E Beck, RN
• Candace Beck, PSY.D.

• Pediatric Dentistry in Dayton, OH
• Providers in Dayton, OH by specialty
• Pediatric Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2026; 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.