MISS PATRICIA RENEE JACKSON
NPI 1023377967
Dentist in Chinle, AZ

Q: What is Patricia Jackson's NPI number?

The NPI number for Patricia Jackson is 1023377967. It was assigned to this individual provider in the NPPES registry on May 13, 2012.

Q: What is Patricia Jackson's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Q: When was this NPI record last updated?

The NPPES record for Patricia Jackson was last updated on October 8, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 13, 2012PECOS Enrolled

191 HIGHWAY AND HOSPITAL ROAD, CHINLE, AZ 86503(928) 674-7166(928) 674-7705 Get Directions Write a Review

NPPES record last updated: October 8, 2013. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Miss Patricia Renee Jackson NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MISS PATRICIA RENEE JACKSON (NPI 1023377967) is an individual dentist in Chinle, Arizona, licensed in Ohio (30.023852) and active in the NPI registry since May 2012. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1023377967

Entity TypeIndividualFemale

Primary Taxonomy122300000X

Provider Legal NameMISS PATRICIA RENEE JACKSON

Location Address191 HIGHWAY AND HOSPITAL ROADChinle, AZ 86503

Mailing AddressPo Drawer PhChinle, AZ 86503 · (928) 674-7166 · Fax (928) 674-7705

Phone(928) 674-7166

Fax(928) 674-7705

Sole ProprietorNo

Enumeration DateMay 13, 2012

Last NPPES UpdateOctober 8, 2013

✔ NPI 1023377967 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

License✔ Licensed in OH · 30.023852

Definition

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

191 HIGHWAY AND HOSPITAL ROAD, Chinle, AZ 86503

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Miss Patricia Renee Jackson is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 86503 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$85.89 typical visit price

range $55.44 – $168.60

Typical copayment $21.47 (range $13.86 – $42.15)

Most-billed visit code 99203

Established Patient

$69.24 typical visit price

range $17.72 – $137.41

Typical copayment $17.31 (range $4.43 – $34.35)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Patricia Jackson's NPI number?

The NPI number for Patricia Jackson is 1023377967. It was assigned to this individual provider in the NPPES registry on May 13, 2012.

Where is Patricia Jackson located?

Patricia Jackson practices at 191 Highway And Hospital Road, Chinle, AZ 86503. The listed phone number is (928) 674-7166.

What is Patricia Jackson's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Patricia Jackson enrolled in Medicare?

Yes. Patricia Jackson is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Patricia Jackson was last updated on October 8, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.