Steven C. Jacks, D.D.S., Inc.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

19745 Issued in OH

Legal business name

STEVEN C. JACKS, D.D.S., INC.

Practice address

7111 N Main St
Dayton, OH 45415-2565

Phone

(937) 277-8959

Fax

(937) 277-6161

NPI assigned

Aug 27, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Steven C. Jacks, D.D.S.NPI 1952320798

Title

President

Phone

(937) 277-8959

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Steven C. Jacks, D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • Piqua, OH
  • NPI 1952320798
  NPD (past) Authorized official

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

{
    "created_epoch": "1188172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1371081600000",
    "number": "1295928844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7111 N MAIN ST",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454152565",
            "telephone_number": "937-277-8959",
            "fax_number": "937-277-6161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7111 N MAIN ST",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454152565",
            "telephone_number": "937-277-8959",
            "fax_number": "937-277-6161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEVEN C. JACKS, D.D.S., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-27",
        "last_updated": "2013-06-13",
        "status": "A",
        "authorized_official_last_name": "JACKS",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "937-277-8959",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "OH",
            "license": "19745",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2005092",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tristin Leigh Stephens
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• Lisa R Stevens-Heaton, LISW
• August Terriana Stevens, RN
• Brianna Reign Stevens, CASE MANAGEMENT
• Cole Michael Stevens
• Colleen Stevens, CDCA

• Oral and Maxillofacial Surgery (Dentist) in Dayton, OH
• Providers in Dayton, OH by specialty
• Oral and Maxillofacial Surgery (Dentist) in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2013; 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.