Jackson Dental Innovations PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

JACKSON DENTAL INNOVATIONS PLLC

Practice address

1931 Horton Rd Ste 14
Jackson, MI 49203-5599

Phone

(517) 787-7520

Fax

(517) 787-2575

NPI assigned

Mar 1, 2024

Organization subpart

No

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

Authorized official

Name

Shadi Krecht, DMD

Title

Owner/Dentist

Phone

(734) 979-0979

Specialties & licenses 1

Addresses

Locations

Practitioners 3

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

• Pinal Rajan Patel, D.D.S

  • General Practice Dentistry
  • Plymouth, MI
  • NPI 1275716151
  NPD (past)
• Richard Campbell Scott, DDS

  • General Practice Dentistry
  • Plymouth, MI
  • NPI 1215044466
  NPD (past)
• Constance Elizabeth Smith, D.D.S.

  • Dentist
  • Jackson, MI
  • NPI 1104858778
  NPD (past)

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

{
    "created_epoch": "1709251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709769600000",
    "number": "1548027063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 PLYMOUTH RD",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481701447",
            "telephone_number": "734-979-0979",
            "fax_number": "734-927-1169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1931 HORTON RD STE 14",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492035599",
            "telephone_number": "517-787-7520",
            "fax_number": "517-787-2575"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "306 W Washington Ave Ste 204",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MI",
            "postal_code": "492012141",
            "country_code": "US",
            "telephone_number": "517-787-8880",
            "fax_number": "517-787-8888",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JACKSON DENTAL INNOVATIONS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-01",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-07",
        "status": "A",
        "authorized_official_last_name": "KRECHT",
        "authorized_official_first_name": "SHADI",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "734-979-0979",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jackson County
• Jackson County Intermediate School District
• Jackson County Medical Care Facility
• Jackson County Youth Center
• Kimberly J Jackson Cwynar, PT
• Jackson Family Medical
• Jackson Family Medical PLLC
• Jackson Gastroenterology Center, LLC
• Jackson Healing
• Jackson Healing Clinic LLC

• Dental Clinic/Center in Jackson, MI
• Providers in Jackson, MI by specialty
• Dental Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.