Brian E Jackson, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

19620 Issued in OH

Practice address

2775 Bishop Rd
Suite C
Willoughby Hills, OH 44092-2683

Phone

(440) 944-7775

Fax

(440) 944-7887

NPI assigned

Nov 1, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Brian E Jackson DDS LLC

  • Durable Medical Equipment & Medical Supplies
  • Willoughby Hills, OH
  • NPI 1306400353
  NPD (past) Authorized official
• Brian E Jackson DDS LLC

  • Dentist
  • Willoughby Hills, OH
  • NPI 1801349154
  NPD (past) Authorized official

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

{
    "created_epoch": "1130803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786665600000",
    "number": "1689665408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2775 BISHOP RD STE C",
            "city": "WILLOUGHBY HILLS",
            "state": "OH",
            "postal_code": "440922683",
            "telephone_number": "440-944-7775",
            "fax_number": "440-944-7887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2775 BISHOP RD",
            "address_2": "SUITE C",
            "city": "WILLOUGHBY HILLS",
            "state": "OH",
            "postal_code": "440922683",
            "telephone_number": "440-944-7775",
            "fax_number": "440-944-7887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "BRIAN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-01",
        "last_updated": "2026-08-14",
        "certification_date": "2026-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "OH",
            "license": "19620",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "19620",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0879287",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Zulfiqar Hussain, M.D.
• Kiely Hutchcroft
• Cheryl Iannicca
• Indu Sivaraman MD LLC
• Madalyn Nicole Issa
• Janae Jackson
• Thurayyah Jackson
• Mark Jakomin
• Alison Renee Janzen, DPT
• Vanessa K Jensen, PSYD

• Dentist in Willoughby Hills, OH
• Providers in Willoughby Hills, OH by specialty
• Dentist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.