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CLAYTON SCOTT JACKSON DMD, MSD
NPI 1225692361
Dentist - Pediatric Dentistry in Louisville, KY

Active since April 24, 2019PECOS Enrolled
3934 DUTCHMANS LN, LOUISVILLE, KY 40207(502) 897-0625(502) 618-4514 Get Directions Write a Review

NPPES record last updated: January 17, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jan 17, 2023, Jul 13, 2021, Apr 24, 2019 (3 updates tracked since 2019).

About Clayton Scott Jackson Dmd, Msd NPPES

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

CLAYTON SCOTT JACKSON DMD, MSD (NPI 1225692361) is an individual pediatric dentistry provider in Louisville, Kentucky, licensed in Kentucky (10852) and active in the NPI registry since April 2019. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1225692361
Entity TypeIndividualMale
Primary Taxonomy1223P0221X
Provider Legal NameCLAYTON SCOTT JACKSONCredential: DMD, MSD
Location Address3934 DUTCHMANS LNLouisville, KY 40207-4702
Mailing Address4317 Charlestown RdNew Albany, IN 47150-8506 · (812) 258-9626 · Fax (812) 213-4190
Phone(502) 897-0625
Fax(502) 618-4514
Sole ProprietorNo
Enumeration DateApril 24, 2019
Last NPPES UpdateJanuary 17, 20233 updates tracked since enumeration
NPPES CertifiedNovember 18, 2022
✔ NPI 1225692361 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers
Taxonomy Code1223P0221X
Licenses✔ Licensed in KY · 10852✔ Licensed in IN · 12013287A
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.
3934 DUTCHMANS LN, Louisville, KY 40207
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Home State Health, Ambetter from Meridian and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Clayton Scott Jackson Dmd, Msd 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 40207 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
$82.24 typical visit price
range $52.76 – $162.27
Typical copayment $20.56 (range $13.19 – $40.56)
Most-billed visit code 99203
Established Patient
$66.24 typical visit price
range $16.53 – $131.99
Typical copayment $16.56 (range $4.13 – $32.99)
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.

Other Providers at the Same Location NPPES 3

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

DUPONT PEDIATRIC DENTISTRY
Dentist (Pediatric Dentistry)
3934 DUTCHMANS LN
LOUISVILLE, KY 40207
Jefferson County (502) 897-0625
DR. SHAZA BASBAR DAFALLA
Dentist (Pediatric Dentistry)
3934 DUTCHMANS LN
LOUISVILLE, KY 40207
Jefferson County (502) 897-0625
NURSING STATION INC.
Durable Medical Equipment & Medical Supplies
3934 DUTCHMANS LN
LOUISVILLE, KY 40207
Jefferson County (502) 721-7727

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 Clayton Jackson's NPI number?

The NPI number for Clayton Jackson is 1225692361. It was assigned to this individual provider in the NPPES registry on April 24, 2019.

Where is Clayton Jackson located?

Clayton Jackson practices at 3934 Dutchmans Ln, Louisville, KY 40207. The listed phone number is (502) 897-0625.

What is Clayton Jackson's specialty?

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

Is Clayton Jackson enrolled in Medicare?

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

What insurance does Clayton Jackson accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Home State Health, Ambetter from Meridian and Ambetter of Tennessee and 14 other insurers list Clayton Jackson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Clayton Jackson was last updated on January 17, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.