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JACKSON PEDIATRIC DENTISTRY LLC
NPI 1144679507
Dentist - Pediatric Dentistry in Rock Hill, SC

Active since June 07, 2016
1236 EBENEZER RD, SUITE 110, ROCK HILL, SC 29732(803) 324-7540(803) 324-4128 Get Directions Write a Review

NPPES record last updated: August 3, 2016. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Jackson Pediatric Dentistry Llc NPPES

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

JACKSON PEDIATRIC DENTISTRY LLC (NPI 1144679507) is a healthcare organization registered as a pediatric dentistry in Rock Hill, South Carolina and active in the NPI registry since June 2016. The organization lists Stephanie Lynn Jackson, Pediatric Dentist, as its authorized official.

NPPES Registry Identity

NPI1144679507
Entity TypeOrganization
Primary Taxonomy1223P0221X
Legal Business NameJACKSON PEDIATRIC DENTISTRY LLC
Location Address1236 EBENEZER RD, SUITE 110Rock Hill, SC 29732-3390
Mailing Address1686 Highway 160 WFort Mill, SC 29708-8024 · (803) 548-2333 · Fax (803) 548-2703
Phone(803) 324-7540
Fax(803) 324-4128
Organization SubpartNo
Authorized OfficialStephanie Lynn JacksonPediatric Dentist · (919) 412-4199
Enumeration DateJune 7, 2016
Last NPPES UpdateAugust 3, 2016
✔ NPI 1144679507 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers
Taxonomy Code1223P0221X
Definition

An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.

1236 EBENEZER RD, Rock Hill, SC 29732
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. LAUREN PAUL DEAN DMD
Dentist (Pediatric Dentistry)
1236 EBENEZER RD
ROCK HILL, SC 29732
York County (803) 548-2333
CHARLES H. CRAWFORD, JR DMD
Dentist (Pediatric Dentistry)
1236 EBENEZER RD, SUITE 110
ROCK HILL, SC 29732
York County (803) 324-7540
DR. CHARLES HARMON CRAWFORD JR. DMD
Dentist (Pediatric Dentistry)
1236 EBENEZER RD, STE 110
ROCK HILL, SC 29732
York County (803) 324-7540
DR. ALEXANDER JOSEPH CULP D.M.D.
Dentist (General Practice)
1236 EBENEZER RD, SUITE 100
ROCK HILL, SC 29732
York County (803) 324-2921

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 Jackson Pediatric Dentistry LLC's NPI number?

The NPI number for Jackson Pediatric Dentistry LLC is 1144679507. It was assigned to this organization in the NPPES registry on June 7, 2016.

Where is Jackson Pediatric Dentistry LLC located?

Jackson Pediatric Dentistry LLC is located at 1236 Ebenezer Rd Suite 110, Rock Hill, SC 29732. The listed phone number is (803) 324-7540.

What is Jackson Pediatric Dentistry LLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Pediatric Dentistry, with taxonomy code 1223P0221X.

When was this NPI record last updated?

The NPPES record for Jackson Pediatric Dentistry LLC was last updated on August 3, 2016. NPI Profile syncs with the weekly NPPES data releases published by CMS.