Marvin Blane Jackson, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

D010196 Issued in AZ

Practice address

6200 S McClintock Dr Ste 111
Tempe, AZ 85283-3449

Phone

(602) 485-1588

Fax

(602) 707-9740

NPI assigned

Aug 13, 2007

Last updated

Aug 14, 2026By the provider in NPPES

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Canyon Vista Dental

  • General Practice Dentistry
  • Sierra Vista, AZ
  • NPI 1518515212
  NPD Authorized official
• TN Dentistry

  • Dentist
  • Tempe, AZ
  • NPI 1902566896
  NPD Authorized official
• A Perfect Smile LLC

  • Dental Clinic/Center
  • Tempe, AZ
  • NPI 1760084255
  NPD (past) Authorized official
• Core Family Dental

  • Dental Clinic/Center
  • Peoria, AZ
  • NPI 1689283814
  Authorized official Same address or phone
• Desert Rose Dental

  • Dental Clinic/Center
  • Tucson, AZ
  • NPI 1841883691
  NPD (past) Authorized official
• Family Dental Phoenix

  • Dental Clinic/Center
  • Phoenix, AZ
  • NPI 1205445749
  Authorized official Same address or phone
• Magnolia Dental LLC

  • Dental Clinic/Center
  • Mesa, AZ
  • NPI 1508684267
  Authorized official Same address or phone
• The River's Edge Dental

  • General Practice Dentistry
  • Coolidge, AZ
  • NPI 1265085567
  Authorized official Same address or phone
• A Perfect Smile

  • Dental Clinic/Center
  • Price, UT
  • NPI 1114314747
  NPD (past) Authorized official

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

{
    "created_epoch": "1186963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786665600000",
    "number": "1265624332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 N FAIRGROUNDS RD",
            "city": "PRICE",
            "state": "UT",
            "postal_code": "845014205",
            "telephone_number": "435-637-2100",
            "fax_number": "435-612-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6200 S MCCLINTOCK DR STE 111",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852833449",
            "telephone_number": "602-485-1588",
            "fax_number": "602-707-9740"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8275 N Silverbell Rd",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857435308",
            "country_code": "US",
            "telephone_number": "435-637-2100",
            "fax_number": "435-637-5007",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "230 N Fairgrounds Rd",
            "address_purpose": "LOCATION",
            "city": "Price",
            "state": "UT",
            "postal_code": "845014205",
            "country_code": "US",
            "telephone_number": "435-637-2100",
            "fax_number": "435-637-5007",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "MARVIN",
        "middle_name": "BLANE",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-13",
        "last_updated": "2026-08-14",
        "certification_date": "2026-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "UT",
            "license": "6605138-9921",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D010196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• J Val Barrett DO PLLC
• J Wu Anesthesia PLLC
• J. Somal, M.D. Anesthesia, PLLC
• Lois Marie Jablonski
• Ava Rose Jackson-Bourne
• Stephanie Ann Jackson, MSW
• Tamara L Jackson, LMSW
• Zipporah Hezekiah Jackson
• Carly Jacobs, MT-BC
• Daniel Aaron Jacobs, M.D.

• Dentist in Tempe, AZ
• Providers in Tempe, AZ by specialty
• Dentist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 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.