Active NPI
Richard Jackson, DMD
- General Practice Dentistry
- Aiken, SC
National Provider Identifier
1629409420
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 3492
- Practice address
- 2759 Whiskey Rd
Aiken, SC 29803-6197 - Phone
- (803) 649-3411
- NPI assigned
- Dec 3, 2013
- Last updated
- Dec 3, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 3492 | SC | Primary |
Addresses
Primary practice location
2759 Whiskey Rd
Aiken, SC 29803-6197
Mailing address
2759 Whiskey Rd
Aiken, SC 29803-6197
Phone (803) 649-3411
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3492 | SC | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| R. Scott Jackson DMD PC | General Practice | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Practice Dentistry
- Aiken, SC
- NPI 1285777268
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1386028800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1386028800000",
"number": "1629409420",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2759 WHISKEY RD",
"city": "AIKEN",
"state": "SC",
"postal_code": "298036197",
"telephone_number": "803-649-3411"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2759 WHISKEY RD",
"city": "AIKEN",
"state": "SC",
"postal_code": "298036197",
"telephone_number": "803-649-3411"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "RICHARD",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-12-03",
"last_updated": "2013-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "SC",
"license": "3492",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Aiken, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 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.