Active NPI
David Edward Jackson, DDS
- Dentist
- Sandy, UT
National Provider Identifier
1750331773
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 138455-9922
- Practice address
- 870 E 9400 S
#110
Sandy, UT 84094-3666 - Phone
- (801) 571-8391
- Fax
- (801) 571-8285
- NPI assigned
- May 11, 2006
- Last updated
- Jul 13, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 138455-9922 | UT | Primary |
Addresses
Primary practice location
870 E 9400 S
#110
Sandy, UT 84094-3666
Mailing address
4327 Hidden Quail Cir
Holladay, UT 84124-3600
Phone (801) 278-9898
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 138455-9922 | UT | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Matsumori Dental, PLLC | Past | Accepting new patients | |
| Dr. David E. Jackson DDS PC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- General Practice Dentistry
- Sandy, UT
- NPI 1881908622
-
- Dental Clinic/Center
- Sandy, UT
- NPI 1114324456
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147305600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1750331773",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4327 HIDDEN QUAIL CIR",
"city": "HOLLADAY",
"state": "UT",
"postal_code": "841243600",
"telephone_number": "801-278-9898",
"fax_number": "801-571-8285"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "870 E 9400 S",
"address_2": "#110",
"city": "SANDY",
"state": "UT",
"postal_code": "840943666",
"telephone_number": "801-571-8391",
"fax_number": "801-571-8285"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "DAVID",
"middle_name": "EDWARD",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-11",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "UT",
"license": "138455-9922",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sandy, UT
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.