David P Jackson DDS, PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6979 Issued in CO

Legal business name

DAVID P JACKSON DDS, PC

Practice address

3393 Iris Ave
Suite 103
Boulder, CO 80301-5205

Phone

(303) 447-2872

Fax

(303) 447-2896

NPI assigned

Sep 8, 2014

Organization subpart

No

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

Authorized official

Name

Dr. David Paul Jackson, DDSNPI 1295955573

Title

Owner/Dentist

Phone

(303) 447-2872

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• David Paul Jackson, DDS

  • Dentist
  • Boulder, CO
  • NPI 1295955573
  NPD (past) Authorized official

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

{
    "created_epoch": "1410134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410134400000",
    "number": "1861893067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3393 IRIS AVE",
            "address_2": "SUITE 103",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803015205",
            "telephone_number": "303-447-2872",
            "fax_number": "303-447-2896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3393 IRIS AVE",
            "address_2": "SUITE 103",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803015205",
            "telephone_number": "303-447-2872",
            "fax_number": "303-447-2896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID P JACKSON DDS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-08",
        "last_updated": "2014-09-08",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "303-447-2872",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "6979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Darnell, PT, DPT
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• Corrine Daves, LAC
• David P. Stangl, Jr., DMD, Professional LLC
• David Sullivan Therapy LLC
• Sofia Mani Davies, DO, MS
• Alexander Mark Davis
• Alison Van Voorhees Davis, NP, RN

• General Practice Dentistry in Boulder, CO
• Providers in Boulder, CO by specialty
• General Practice Dentistry in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2014; 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.