DR. W. JACKSON FAIRCLOTH JR. D.D.S.
NPI 1679595003
Dentist - Oral and Maxillofacial Surgery in Charlottesville, VA

Q: What is W. Jackson Faircloth's NPI number?

The NPI number for W. Jackson Faircloth is 1679595003. It was assigned to this individual provider in the NPPES registry on July 24, 2006.

Q: What is W. Jackson Faircloth's specialty?

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

Q: Is W. Jackson Faircloth enrolled in Medicare?

No. W. Jackson Faircloth has opted out of Medicare through January 29, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

Active since July 24, 2006Opted out of Medicare · through Jan 29, 2028

244 HYDRAULIC RIDGE RD, CHARLOTTESVILLE, VA 22901(434) 973-3348(434) 977-5790 Get Directions Write a Review

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

On this page

About Dr. W. Jackson Faircloth Jr. D.d.s. NPPES

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

DR. W. JACKSON FAIRCLOTH JR. D.D.S. (NPI 1679595003) is an individual oral and maxillofacial surgery provider in Charlottesville, Virginia, licensed in Virginia (0401005586) and active in the NPI registry since July 2006. He has opted out of Medicare through January 29, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1679595003

Entity TypeIndividualMale

Primary Taxonomy1223S0112X

Provider Legal NameDR. W. JACKSON FAIRCLOTH JR.Credential: D.D.S.

Location Address244 HYDRAULIC RIDGE RDCharlottesville, VA 22901-8124

Mailing Address244 Hydraulic Ridge RdCharlottesville, VA 22901-8124 · (434) 973-3348 · Fax (434) 977-5790

Phone(434) 973-3348

Fax(434) 977-5790

Sole ProprietorNo

Enumeration DateJuly 24, 2006

Last NPPES UpdateAugust 8, 2007

✔ NPI 1679595003 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 VA · 0401005586

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.

244 HYDRAULIC RIDGE RD, Charlottesville, VA 22901

Open in Google Maps ↗

Other Identifiers 1

Medicare UPINH56551VA

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. W. Jackson Faircloth Jr. D.d.s. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 29, 2016 through January 29, 2028.

Opt-Out Effective DateJanuary 29, 2016

Opt-Out In Effect ThroughJanuary 29, 2028Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 22901 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

$86.88 typical visit price

range $56.19 – $170.30

Typical copayment $21.72 (range $14.04 – $42.57)

Most-billed visit code 99203

Established Patient

$70.08 typical visit price

range $18.07 – $138.91

Typical copayment $17.52 (range $4.51 – $34.72)

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 9

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

SARAH ELIZABETH SNOW SUMMERS DMD, MD

Oral & Maxillofacial Surgery