Scott Robert Jackson DDS PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2532 Issued in AZ

Legal business name

SCOTT ROBERT JACKSON DDS PC

Practice address

13660 N 94TH Dr
Suite A1 Plaza del Rio Medical Center
Peoria, AZ 85381-4836

Phone

(623) 933-0550

Fax

(623) 933-2722

NPI assigned

Oct 4, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Scott Robert Jackson, DDS PC

Title

President

Phone

(623) 933-0550

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1932294741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13660 N 94TH DR",
            "address_2": "SUITE #A1",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814836",
            "telephone_number": "623-933-0550",
            "fax_number": "623-933-2722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13660 N 94TH DR",
            "address_2": "SUITE A1 PLAZA DEL RIO MEDICAL CENTER",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814836",
            "telephone_number": "623-933-0550",
            "fax_number": "623-933-2722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCOTT ROBERT JACKSON DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "623-933-0550",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS PC"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "2532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eugenia Vasilakos Schuhmacher, MA CCC SLP
• Jean C Schulman, MD
• Joseph Schwartz, DPT
• Ronald Michael Schwartz, D.O.
• Steven Michael Schwartz, FNP-C
• Chelsea Scott
• Sean Joseph Scully, DPT
• Kara E Seabrook, PA-C
• Elizabeth Sears
• Karla Ann Sears, LPC

• General Practice Dentistry in Peoria, AZ
• Providers in Peoria, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.