Individual provider Active NPI

Vanessa Yepez Jackson, STUDENT

  • Dentist
  • Fayetteville, NC
National Provider Identifier
1548989130
Registry record updated Oct 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
14238 Issued in NC
Practice address
265 Westlake Rd
Fayetteville, NC 28314-4869
Phone
(910) 864-2944
NPI assigned
Aug 25, 2022
Last updated
Oct 8, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 14238 NC Primary

Addresses

Primary practice location

265 Westlake Rd
Fayetteville, NC 28314-4869

Mailing address

5668 Juneberry LN
Fayetteville, NC 28304-4859
Phone (910) 885-3431

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1661385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791417600000",
    "number": "1548989130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5668 JUNEBERRY LN",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283044859",
            "telephone_number": "910-885-3431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "265 WESTLAKE RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283144869",
            "telephone_number": "910-864-2944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "VANESSA",
        "middle_name": "YEPEZ",
        "credential": "STUDENT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-25",
        "last_updated": "2026-10-08",
        "certification_date": "2026-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "14238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 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.