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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

JACKSON DERRICK DMD
NPI 1245171776
Dentist in Abingdon, VA

Active since April 01, 2026
616 CAMPUS DR STE 100, ABINGDON, VA 24210(276) 525-4487 Get Directions Write a Review

NPPES record last updated: June 29, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Jackson Derrick Dmd NPPES

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

JACKSON DERRICK DMD (NPI 1245171776) is an individual dentist in Abingdon, Virginia, licensed in Virginia (0401420083) and active in the NPI registry since April 2026.

NPPES Registry Identity

NPI1245171776
Entity TypeIndividualMale
Primary Taxonomy122300000X
Provider Legal NameJACKSON DERRICKCredential: DMD
Location Address616 CAMPUS DR STE 100Abingdon, VA 24210-9706
Mailing Address225 Mallard DrChapin, SC 29036-8265
Phone(276) 525-4487
Sole ProprietorYes
Enumeration DateApril 1, 2026
Last NPPES UpdateJune 29, 2026
NPPES CertifiedJune 29, 2026
✔ NPI 1245171776 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in VA · 0401420083
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.
616 CAMPUS DR STE 100, Abingdon, VA 24210
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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 20

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

LAURA ROSE BRAILSFORD DMD
Dentist (General Practice)
616 CAMPUS DR STE 100
ABINGDON, VA 24210
Washington County (276) 525-4487
DR. JAMES ZACHARY JONES DMD MPH
Dentist
616 CAMPUS DR STE 100
ABINGDON, VA 24210
Washington County (276) 525-4487
SARA HOLSTON
Dentist
616 CAMPUS DR STE 100
ABINGDON, VA 24210
Washington County (276) 525-4487
WILLIAM MCNEIL WELBORNE D.D.S.
Dentist (General Practice)
616 CAMPUS DR STE 100
ABINGDON, VA 24210
Washington County (276) 525-4487
DR. BRANDON SINGH DDS
Dentist (General Practice)
616 CAMPUS DR STE 100
ABINGDON, VA 24210
Washington County (276) 525-4487
TARA SCHRAM
Dentist
616 CAMPUS DR STE 100
ABINGDON, VA 24210
Washington County (276) 525-4487
KARA MADISON BOOTH DDS
Dentist
616 CAMPUS DR STE 100
ABINGDON, VA 24210
Washington County (276) 525-5587
HUNTER C SMITH DDS
Dentist
616 CAMPUS DR STE 100
ABINGDON, VA 24210
Washington County (276) 525-4487

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 Derrick's NPI number?

The NPI number for Jackson Derrick is 1245171776. It was assigned to this individual provider in the NPPES registry on April 1, 2026.

Where is Jackson Derrick located?

Jackson Derrick practices at 616 Campus Dr Ste 100, Abingdon, VA 24210. The listed phone number is (276) 525-4487.

What is Jackson Derrick's specialty?

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

When was this NPI record last updated?

The NPPES record for Jackson Derrick was last updated on June 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 55 days 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.