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LYNNETTE JACKSON DDS
NPI 1447392311
Dentist - Oral and Maxillofacial Surgery in Los Angeles, CA

Active since February 13, 2007
12012 S WILMINGTON AVENUE, LOS ANGELES, CA 90059(310) 668-4515(310) 763-8909 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Lynnette Jackson Dds NPPES

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

LYNNETTE JACKSON DDS (NPI 1447392311) is an individual oral and maxillofacial surgery provider in Los Angeles, California, licensed in California (29305) and active in the NPI registry since February 2007.

NPPES Registry Identity

NPI1447392311
Entity TypeIndividualFemale
Primary Taxonomy1223S0112X
Provider Legal NameLYNNETTE JACKSONCredential: DDS
Location Address12012 S WILMINGTON AVENUELos Angeles, CA 90059
Mailing Address1032 Loma Lisa LaneArcadia, CA 91006
Phone(310) 668-4515
Fax(310) 763-8909
Sole ProprietorNo
Enumeration DateFebruary 13, 2007
Last NPPES UpdateJuly 8, 2007
✔ NPI 1447392311 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
License✔ Licensed in CA · 29305
Definition
An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
12012 S WILMINGTON AVENUE, Los Angeles, CA 90059
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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.

BARTHOLOMEW GILLIAM PA-C
Physician Assistant
12012 S WILMINGTON AVENUE
LOS ANGELES, CA 90059
Los Angeles County (310) 668-4515
MS. ROBABEH AZARI NMW
Registered Nurse
12012 S WILMINGTON AVENUE
LOS ANGELES, CA 90059
Los Angeles County (310) 668-4515
DR. DAPHNE CALMES MD
Pediatrics
12012 S WILMINGTON AVENUE
LOS ANGELES, CA 90059
Los Angeles County (310) 668-4515
DELY CHUA RNP
Registered Nurse
12012 S WILMINGTON AVENUE
LOS ANGELES, CA 90059
Los Angeles County (310) 668-4515
JUN GOEKU PA-C
Physician Assistant
12012 S WILMINGTON AVENUE
LOS ANGELES, CA 90059
Los Angeles County (310) 668-4515

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 Lynnette Jackson's NPI number?

The NPI number for Lynnette Jackson is 1447392311. It was assigned to this individual provider in the NPPES registry on February 13, 2007.

Where is Lynnette Jackson located?

Lynnette Jackson practices at 12012 S Wilmington Avenue, Los Angeles, CA 90059. The listed phone number is (310) 668-4515.

What is Lynnette Jackson's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

When was this NPI record last updated?

The NPPES record for Lynnette Jackson 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.