Jackilyn Dang, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

27231 Issued in TX

Practice address

3851 SW Green Oaks Blvd
#100
Arlington, TX 76017-4130

Phone

(817) 789-4488

Fax

(817) 541-4471

NPI assigned

Aug 15, 2011

Last updated

Jan 3, 2024By 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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Ivodent Group, PLLC

  dba Great Oak Dental

  • Dental Clinic/Center
  • Arlington, TX
  • NPI 1023356359
  NPD (past) Authorized official
• Ivodent Group PLLC

  dba Legacy Park Dental

  • General Practice Dentistry
  • Arlington, TX
  • NPI 1093119331
  NPD (past)

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

{
    "created_epoch": "1313366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704240000000",
    "number": "1386923811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3851 SW GREEN OAKS BLVD",
            "address_2": "STE 101",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760174130",
            "telephone_number": "817-789-4488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3851 SW GREEN OAKS BLVD",
            "address_2": "#100",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760174130",
            "telephone_number": "817-789-4488",
            "fax_number": "817-541-4471"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 NE Green Oaks Blvd Ste 129",
            "address_purpose": "LOCATION",
            "city": "Arlington",
            "state": "TX",
            "postal_code": "760062300",
            "country_code": "US",
            "telephone_number": "817-789-4480",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DANG",
        "first_name": "JACKILYN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-15",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "27231",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "27231",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "282677802",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "800851489",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dancer Home Health Care Services, LLC
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• Gloria Dang, PHARMD
• Hung T Dang, M.D.
• Daniel Max & Marcandrea LLC (My EyeLab)
• Daniel S. Lim PLLC (Oak Dentistry)
• Amanda Marie Daniel
• Clifton R Daniel, MD
• Danielle R. Ford MD, PLLC

• Dentist in Arlington, TX
• Providers in Arlington, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 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.