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JACKSON FAMILY DENTAL GLADSTONE LLC
NPI 1194115865
Dentist - General Practice in Gladstone, MO

Active since February 02, 2015
2109 NE 72ND ST, STE 104, GLADSTONE, MO 64118(816) 453-3100(816) 453-3180 Get Directions Write a Review

NPPES record last updated: February 2, 2015. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Jackson Family Dental Gladstone Llc NPPES

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

JACKSON FAMILY DENTAL GLADSTONE LLC (NPI 1194115865) is a healthcare organization registered as a general practice in Gladstone, Missouri and active in the NPI registry since February 2015. The organization lists Jesse Lynn Jackson, Member, as its authorized official.

NPPES Registry Identity

NPI1194115865
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameJACKSON FAMILY DENTAL GLADSTONE LLC
Location Address2109 NE 72ND ST, STE 104Gladstone, MO 64118-2304
Mailing Address2109 Ne 72nd St, Ste 104Gladstone, MO 64118-2304 · (816) 453-3100 · Fax (816) 453-3180
Phone(816) 453-3100
Fax(816) 453-3180
Organization SubpartNo
Authorized OfficialJesse Lynn JacksonMember · (816) 429-5799
Enumeration DateFebruary 2, 2015
✔ NPI 1194115865 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
2109 NE 72ND ST, Gladstone, MO 64118
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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 5

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

DR. GREGORY W DALE DDS
Dentist
2109 NE 72ND ST
GLADSTONE, MO 64118
Clay County (816) 452-3420
DR. JAMES H. MUTTI DDS MS
Dentist (Orthodontics and Dentofacial Orthopedics)
2109 NE 72ND ST, STE. 103
GLADSTONE, MO 64118
Clay County (913) 469-9191
GLADSTONE FAMILY DENTAL GROUP.P.C. & ASSOCIATES
Dentist (General Practice)
2109 NE 72ND ST
GLADSTONE, MO 64118
Clay County (816) 452-3420
DR. THOMAS FREDERICK BARTON DDS
Dentist (General Practice)
2109 NE 72ND ST, SUITE 102
GLADSTONE, MO 64118
Clay County (816) 453-0195
DR. DAVID SCOTT PLATT DDS
Dentist (General Practice)
2109 NE 72ND ST, SUITE 101
GLADSTONE, MO 64118
Clay County (816) 452-3420

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 Family Dental Gladstone LLC's NPI number?

The NPI number for Jackson Family Dental Gladstone LLC is 1194115865. It was assigned to this organization in the NPPES registry on February 2, 2015.

Where is Jackson Family Dental Gladstone LLC located?

Jackson Family Dental Gladstone LLC is located at 2109 NE 72nd St Ste 104, Gladstone, MO 64118. The listed phone number is (816) 453-3100.

What is Jackson Family Dental Gladstone LLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for Jackson Family Dental Gladstone LLC was last updated on February 2, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.