NPIMap

Organization Active NPI

Andrew Scott Jackson, DDS, PA

  • General Practice Dentistry
  • Pageland, SC
National Provider Identifier
1225580533
Registry record updated Sep 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
8657 Issued in SC
Legal business name
ANDREW SCOTT JACKSON, DDS, PA
Practice address
1303 South Pearl St
Pageland, SC 29728-0245
Phone
(843) 672-2444
NPI assigned
Nov 3, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2024

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

Authorized official

Name
Dr. Andrew Scott Jackson, D.D.SNPI 1740651843
Title
Owner
Phone
(843) 672-2444

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 8657 SC Primary

Addresses

Primary practice location

1303 South Pearl St
Pageland, SC 29728-0245

Mailing address

P.O. Box 245
1303 South Pearl Street
Pageland, SC 29728-0245
Phone (843) 672-2444

National Provider Directory

National Provider Directory

Locations

1303 S Pearl St
Pageland, SC 29728
Phone (843) 572-8009

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1478131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727222400000",
    "number": "1225580533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 245",
            "address_2": "1303 SOUTH PEARL STREET",
            "city": "PAGELAND",
            "state": "SC",
            "postal_code": "297280245",
            "telephone_number": "843-672-2444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1303 SOUTH PEARL ST",
            "city": "PAGELAND",
            "state": "SC",
            "postal_code": "297280245",
            "telephone_number": "843-672-2444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDREW SCOTT JACKSON, DDS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-03",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-672-2444",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "8657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pageland, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2024; 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.