Central Virginia Dental Care

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

CENTRAL VIRGINIA DENTAL CARE

Doing business as

Lakeside Dental Center, P.C.

Practice address

6113 Lakeside Ave
Richmond, VA 23228-5236

Phone

(804) 262-9824

Fax

(804) 264-2834

NPI assigned

Oct 20, 2026

Last updated

Oct 20, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Clayton Forrest Jackson, DDS

Title

President, Owner

Phone

(703) 638-8104

Specialties & licenses 1

Addresses

Other names 1

• Lakeside Dental Center, P.C. Doing business as

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

{
    "created_epoch": "1792454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1792454400000",
    "number": "1669378170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6113 LAKESIDE AVE",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232285236",
            "telephone_number": "804-262-9824",
            "fax_number": "804-264-2834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6113 LAKESIDE AVE",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232285236",
            "telephone_number": "804-262-9824",
            "fax_number": "804-264-2834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL VIRGINIA DENTAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-10-20",
        "last_updated": "2026-10-20",
        "certification_date": "2026-10-20",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "CLAYTON",
        "authorized_official_middle_name": "FORREST",
        "authorized_official_title_or_position": "PRESIDENT, OWNER",
        "authorized_official_telephone_number": "703-638-8104",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakeside Dental Center, P.C.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Richmond, VA
• Providers in Richmond, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 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.