DR. JACKSON D FORDHAM DMD
NPI 1699858001
Dentist in Dublin, GA

Q: What is Jackson Fordham's NPI number?

The NPI number for Jackson Fordham is 1699858001. It was assigned to this individual provider in the NPPES registry on October 23, 2006.

Q: What is Jackson Fordham's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Jackson Fordham was last updated on June 20, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.

Active since October 23, 2006PECOS Enrolled

204 FAIRVIEW PARK DR, DUBLIN, GA 31021(478) 272-4051(478) 272-3310 Get Directions Write a Review

NPPES record last updated: June 20, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Dr. Jackson D Fordham Dmd NPPES

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

DR. JACKSON D FORDHAM DMD (NPI 1699858001) is an individual dentist in Dublin, Georgia, licensed in Georgia (9503) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1699858001

Entity TypeIndividualMale

Primary Taxonomy122300000X

Provider Legal NameDR. JACKSON D FORDHAMCredential: DMD

Location Address204 FAIRVIEW PARK DRDublin, GA 31021-2547

Mailing Address204 Fairview Park DrDublin, GA 31021-2547 · (478) 272-4051 · Fax (478) 272-3310

Phone(478) 272-4051

Fax(478) 272-3310

Sole ProprietorYes

Enumeration DateOctober 23, 2006

Last NPPES UpdateJune 20, 2016

✔ NPI 1699858001 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

License✔ Licensed in GA · 9503

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.

204 FAIRVIEW PARK DR, Dublin, GA 31021

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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. Jackson D Fordham Dmd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 31021 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

$83.23 typical visit price

range $53.31 – $164.04

Typical copayment $20.80 (range $13.32 – $41.01)

Most-billed visit code 99203

Established Patient

$66.89 typical visit price

range $16.68 – $133.24

Typical copayment $16.72 (range $4.17 – $33.31)

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

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

DR. RICHARD K CLARDY D.M.D.

Dentist (General Practice)

204 FAIRVIEW PARK DR
DUBLIN, GA 31021

Laurens County (478) 272-6777

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 Fordham's NPI number?

The NPI number for Jackson Fordham is 1699858001. It was assigned to this individual provider in the NPPES registry on October 23, 2006.

Where is Jackson Fordham located?

Jackson Fordham practices at 204 Fairview Park Dr, Dublin, GA 31021. The listed phone number is (478) 272-4051.

What is Jackson Fordham's specialty?

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

Is Jackson Fordham enrolled in Medicare?

Yes. Jackson Fordham is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jackson Fordham was last updated on June 20, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.