Dana M Jackson, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5769 Issued in LA

Practice address

7101 Pines Rd
Shreveport, LA 71129-3403

Phone

(318) 686-2015

Fax

(318) 686-2018

NPI assigned

Jul 13, 2006

Last updated

Sep 2, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788307200000",
    "number": "1225053531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7101 PINES RD",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711293403",
            "telephone_number": "318-686-2015",
            "fax_number": "318-686-2018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7101 PINES RD",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711293403",
            "telephone_number": "318-686-2015",
            "fax_number": "318-686-2018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "DANA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-13",
        "last_updated": "2026-09-02",
        "certification_date": "2026-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "5769",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019-025879",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chelsa T Jackson
• Christina Renee' Jackson
• Claire Jackson
• Clarke Jackson
• Dana Jackson
• Dannisha Jackson, MHS
• Deaquanita Shehalorenza Jackson
• Destiny Jackson, M.A., PLPC, PLMFT
• Destiny Jackson
• Dijuan Jackson

• General Practice Dentistry in Shreveport, LA
• Providers in Shreveport, LA by specialty
• General Practice Dentistry in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.