Individual provider Active NPI

Craig W Jackson, DDS

  • General Practice Dentistry
  • Hilton Head Island, SC
National Provider Identifier
1235192469
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3926 Issued in SC
Practice address
25 Hospital Center Blvd
Hospital Medical Pavilion, Suite 102
Hilton Head Island, SC 29926-2738
Phone
(843) 689-5500
Fax
(843) 689-6600
NPI assigned
Apr 10, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 3926 SC Primary

Addresses

Primary practice location

25 Hospital Center Blvd
Hospital Medical Pavilion, Suite 102
Hilton Head Island, SC 29926-2738

Mailing address

25 Hospital Center Blvd
Hospital Medical Pavilion, Suite 102
Hilton Head Island, SC 29926-2738
Phone (843) 689-5500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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

Enrollment IDStateProvider typePAC IDDetails
I20160526000414 SC Order and Referring Only - DentistPractitioner - Dentist 7113217548

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1235192469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 HOSPITAL CENTER BLVD",
            "address_2": "HOSPITAL MEDICAL PAVILION, SUITE 102",
            "city": "HILTON HEAD ISLAND",
            "state": "SC",
            "postal_code": "299262738",
            "telephone_number": "843-689-5500",
            "fax_number": "843-689-6600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 HOSPITAL CENTER BLVD",
            "address_2": "HOSPITAL MEDICAL PAVILION, SUITE 102",
            "city": "HILTON HEAD ISLAND",
            "state": "SC",
            "postal_code": "299262738",
            "telephone_number": "843-689-5500",
            "fax_number": "843-689-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "CRAIG",
        "middle_name": "W",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-10",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "3926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hilton Head Island, SC

Sources for this page

Verify at the official NPI Registry.