Jackson Spiller, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

255855 Issued in AK

Practice address

290 Arbor Ave
Soldotna, AK 99669-7664

Phone

(907) 262-3119

Fax

(907) 262-9290

NPI assigned

Mar 18, 2026

Last updated

Aug 6, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Musc College of Dental Medicine

  • Dental Clinic/Center
  • Charleston, SC
  • NPI 1952517161

  General Practice

  NPD (past)

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

{
    "created_epoch": "1773792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785974400000",
    "number": "1679421366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2949",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996692949",
            "telephone_number": "907-283-7759",
            "fax_number": "907-283-4883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 ARBOR AVE",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996697664",
            "telephone_number": "907-262-3119",
            "fax_number": "907-262-9290"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "395 Main Street Loop",
            "address_purpose": "LOCATION",
            "city": "Kenai",
            "state": "AK",
            "postal_code": "996117727",
            "country_code": "US",
            "telephone_number": "907-262-3119",
            "fax_number": "907-262-9290",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPILLER",
        "first_name": "JACKSON",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-03-18",
        "last_updated": "2026-08-06",
        "certification_date": "2026-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AK",
            "license": "255855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• South Sound Inpatient Physicians (Sound Physicians)
• George P Spady, MD
• Caitlin Riley Sparks, LMT
• David Spence
• Alice Spencer, DPT
• Amy Joyce Spilman
• Kerry A Spooner
• Sandy G St. John
• Brianna Stang
• Steven D. Stauber, LCSW

• General Practice Dentistry in Soldotna, AK
• Providers in Soldotna, AK by specialty
• General Practice Dentistry in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 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.