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DR. LUE DEE JACKSON JR. DMD, MD
NPI 1568623841
Dentist in Roxbury, MA

Active since June 19, 2008PECOS Enrolled
386 A-B WARREN STREET, ROXBURY, MA 02119(800) 676-2750 Get Directions Write a Review

NPPES record last updated: June 19, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Lue Dee Jackson Jr. Dmd, Md NPPES

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

DR. LUE DEE JACKSON JR. DMD, MD (NPI 1568623841) is an individual dentist in Roxbury, Massachusetts, licensed in Massachusetts (15374) and active in the NPI registry since June 2008. He is enrolled in Medicare PECOS and is a graduate of Other (1979).

NPPES Registry Identity

NPI1568623841
Entity TypeIndividualMale
Primary Taxonomy122300000X
Provider Legal NameDR. LUE DEE JACKSON JR.Credential: DMD, MD
Location Address386 A-B WARREN STREETRoxbury, MA 02119
Mailing Address18 Claremont ParkBoston, MA 02118-3002 · (800) 676-2750
Phone(800) 676-2750
Sole ProprietorYes
Medical School CMSOtherGraduated 1979
Enumeration DateJune 19, 2008
✔ NPI 1568623841 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in MA · 15374
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.
386 A-B WARREN STREET, Roxbury, MA 02119
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Other Identifiers 1

Medicaid0262331MA

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Lue Dee Jackson Jr. Dmd, Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID2365923406
PECOS Enrollment IDI20260226000464
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 02119 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
$97.64 typical visit price
range $63.72 – $189.86
Typical copayment $24.41 (range $15.93 – $47.46)
Most-billed visit code 99203
Established Patient
$78.84 typical visit price
range $21.07 – $155.29
Typical copayment $19.71 (range $5.26 – $38.82)
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.

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 Lue Dee Jackson's NPI number?

The NPI number for Lue Dee Jackson is 1568623841. It was assigned to this individual provider in the NPPES registry on June 19, 2008.

Where is Lue Dee Jackson located?

Lue Dee Jackson practices at 386 A-B Warren Street, Roxbury, MA 02119. The listed phone number is (800) 676-2750.

What is Lue Dee Jackson's specialty?

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

Is Lue Dee Jackson enrolled in Medicare?

Yes. Lue Dee Jackson is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Lue Dee Jackson was last updated on June 19, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.