Dolphus Carl Jackson, D.D.S., P.C.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DS0000008035 Issued in TN

Practice address

4012 Ohallorn Dr Ste a
Spring Hill, TN 37174-2214

Phone

(615) 302-8471

Fax

(615) 302-8081

NPI assigned

Dec 6, 2006

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

Other identifiers 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• Center for Oral & Facial Surgery, PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Nashville, TN
  • NPI 1780700559
  NPD (past)
• Middle Tennessee Oral Surgery Center

  • Oral and Maxillofacial Surgery (Dentist)
  • Nashville, TN
  • NPI 1659546455
  NPD (past)
• Oral Surgical Institute, P.C.

  • Oral and Maxillofacial Surgery (Dentist)
  • Nashville, TN
  • NPI 1144298050
  NPD (past)
• Oral Surgical Institute, P.C.

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Franklin, TN
  • NPI 1740683143
  NPD (past)

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741737600000",
    "number": "1467511642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4012 OHALLORN DR STE A",
            "city": "SPRING HILL",
            "state": "TN",
            "postal_code": "371742214",
            "telephone_number": "615-302-8471",
            "fax_number": "615-302-8081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4012 OHALLORN DR STE A",
            "city": "SPRING HILL",
            "state": "TN",
            "postal_code": "371742214",
            "telephone_number": "615-302-8471",
            "fax_number": "615-302-8081"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1801 Church St",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372032201",
            "country_code": "US",
            "telephone_number": "615-327-2494",
            "fax_number": "615-327-2607",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "DOLPHUS",
        "middle_name": "CARL",
        "name_prefix": "Dr.",
        "credential": "D.D.S., P.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-06",
        "last_updated": "2025-03-12",
        "certification_date": "2025-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TN",
            "license": "DS08035",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TN",
            "license": "DS0000008035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASSURANT EMPLOYEE BNFTS",
            "identifier": "0015802",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TENNCARE SELECT",
            "identifier": "4105175",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3731118",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DORAL USA",
            "identifier": "9176594",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA DMO DENTAL PLAN",
            "identifier": "281433",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TENNESSEE",
            "identifier": "4105175",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Independent Physical Therapy
• Jessica Marie Inglis, OT
• Inspire Senior Care
• Integrated Health Center, Inc
• Christina Isong, MS, ATC-L
• Lisa Jackson
• Amanda Michele Jefferson, PTA
• Kristina Jefferson
• Aletha Jenkins
• Jeremy Charles Johnson

• Oral and Maxillofacial Surgery (Dentist) in Spring Hill, TN
• Providers in Spring Hill, TN by specialty
• Oral and Maxillofacial Surgery (Dentist) in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2025; 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.