Bruce Arden Jackson II, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

13162 Issued in MI

Practice address

4829 E Beltline Ave NE
Grand Rapids, MI 49525-9747

Phone

(616) 363-8707

Fax

(616) 363-0390

NPI assigned

May 13, 2006

Last updated

Jul 13, 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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

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

Locations

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.

• Alpine Family Dentistry Acquisition PLC

  • Dental Clinic/Center
  • Comstock Park, MI
  • NPI 1336753839
  NPD Authorized official
• Bruce a. Jackson II, DDS, PLC

  • Dental Clinic/Center
  • Grand Rapids, MI
  • NPI 1639783137
  NPD Authorized official
• Hopkins Family Dentistry & Orthodontics

  dba Hopkins Family Dentistry

  • General Practice Dentistry
  • Hopkins, MI
  • NPI 1114660487
  NPD Authorized official

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

{
    "created_epoch": "1147478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1720039878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4829 E BELTLINE AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259747",
            "telephone_number": "616-363-8707",
            "fax_number": "616-363-0390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4829 E BELTLINE AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259747",
            "telephone_number": "616-363-8707",
            "fax_number": "616-363-0390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "BRUCE",
        "middle_name": "ARDEN",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-13",
        "last_updated": "2026-07-13",
        "certification_date": "2020-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "13162",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4066190",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Diana Jackson-Whitfield, MA/LBSW
• Allen Jackson
• Amy Jackson
• Annie Jackson, OTR/L
• Archia Denise Jackson, REGISTERED NURSE
• Caitlin Jackson
• Dominique Jackson
• Elizabeth Anne Jackson, PMHNP
• Hayley Jackson, OTD
• Ja'Daisha Jackson

• General Practice Dentistry in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.