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JERRY JACK DDS
NPI 1265463467
Dentist - General Practice in Moore, OK

Active since July 05, 2006
1740 N SERVICE RD, MOORE, OK 73160(405) 794-7200(405) 794-2266 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jerry Jack Dds NPPES

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

JERRY JACK DDS (NPI 1265463467) is an individual general practice provider in Moore, Oklahoma, licensed in Oklahoma (3903) and active in the NPI registry since July 2006.

NPPES Registry Identity

NPI1265463467
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameJERRY JACKCredential: DDS
Location Address1740 N SERVICE RDMoore, OK 73160-3307
Mailing Address555 W Benjamin Holt Dr, Building BStockton, CA 95207-3839 · (209) 476-4700 · Fax (209) 478-6890
Phone(405) 794-7200
Fax(405) 794-2266
Sole ProprietorNo
Enumeration DateJuly 5, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1265463467 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in OK · 3903
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.
1740 N SERVICE RD, Moore, OK 73160
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Other Providers at the Same Location NPPES

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

RONALD MONTGOMERY DENTAL GROUP, PC
Dentist (General Practice)
1740 N SERVICE RD
MOORE, OK 73160
Cleveland County (405) 794-7200

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 Jerry Jack's NPI number?

The NPI number for Jerry Jack is 1265463467. It was assigned to this individual provider in the NPPES registry on July 5, 2006.

Where is Jerry Jack located?

Jerry Jack practices at 1740 N Service Rd, Moore, OK 73160. The listed phone number is (405) 794-7200.

What is Jerry Jack'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 Jerry Jack was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.