Active NPI
Rashawn Wanya Jackson, DDS
- Dentist
- Villa Rica, GA
National Provider Identifier
1801718564
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN124302
- Practice address
- 427 W Bankhead Hwy
Villa Rica, GA 30180-1702 - Phone
- (770) 456-2550
- NPI assigned
- Jul 27, 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 | DN124302 | GA | Primary |
Addresses
Primary practice location
427 W Bankhead Hwy
Villa Rica, GA 30180-1702
Mailing address
PO Box 5052
Douglasville, GA 30154-0001
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1785110400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1785110400000",
"number": "1801718564",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5052",
"city": "DOUGLASVILLE",
"state": "GA",
"postal_code": "301540001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "427 W BANKHEAD HWY",
"city": "VILLA RICA",
"state": "GA",
"postal_code": "301801702",
"telephone_number": "770-456-2550"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "RASHAWN",
"middle_name": "WANYA",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-07-27",
"last_updated": "2026-07-27",
"certification_date": "2026-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "GA",
"license": "DN124302",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Villa Rica, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 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.