Mac Jackson III DMD PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

MAC JACKSON III DMD PLLC

Practice address

13115 NE 4TH St Ste 250
Vancouver, WA 98684-5960

Phone

(541) 490-9126

NPI assigned

Mar 24, 2026

Organization subpart

No

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

Authorized official

Name

Mr. John Pugh

Title

Practice Manager

Phone

(360) 256-7455

Specialties & licenses 1

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mac Roy Jackson III, DMD

  • Dentist
  • Phoenix, AZ
  • NPI 1063102846
  NPD
• Shauna Weil, RDH

  • Dental Hygienist
  • Vancouver, WA
  • NPI 1124560545
  NPD (past)
• Amy Pugh, D.M.D.

  • General Practice Dentistry
  • Crooked River Ranch, OR
  • NPI 1598983132
  NPD (past)

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

{
    "created_epoch": "1774310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778198400000",
    "number": "1750229423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13115 NE 4TH ST STE 250",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986845960",
            "telephone_number": "541-490-9126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13115 NE 4TH ST STE 250",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986845960",
            "telephone_number": "541-490-9126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAC JACKSON III DMD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-24",
        "last_updated": "2026-05-08",
        "certification_date": "2026-05-08",
        "status": "A",
        "authorized_official_last_name": "PUGH",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "360-256-7455",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Xiaofei Ma
• Xinyuan Ma, DMD
• Katya V Maas
• Vernon Mabalay, DC
• Zachary Mabalay, DC
• Christine Renee Macbean, PHARMD
• Isabelle Alexandra Macdonald
• Pippa Macdonald, M.D.
• Janet Robinson Macdonell, M.D.
• Ryan Baxter Macedo, D.C.

• Dental Clinic/Center in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Dental Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 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.