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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

DR. BRUCE ARDEN JACKSON II DDS
NPI 1720039878
Dentist - General Practice in Grand Rapids, MI

Active since May 13, 2006PECOS Enrolled
4829 E BELTLINE AVE NE, GRAND RAPIDS, MI 49525(616) 363-8707(616) 363-0390 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 13, 2026, Sep 2, 2020 (2 updates tracked since 2020).

About Dr. Bruce Arden Jackson Ii Dds NPPES

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

DR. BRUCE ARDEN JACKSON II DDS (NPI 1720039878) is an individual general practice provider in Grand Rapids, Michigan, licensed in Michigan (13162) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1720039878
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameDR. BRUCE ARDEN JACKSON IICredential: DDS
Location Address4829 E BELTLINE AVE NEGrand Rapids, MI 49525-9747
Mailing Address4829 E Beltline Ave NeGrand Rapids, MI 49525-9747 · (616) 363-8707 · Fax (616) 363-0390
Phone(616) 363-8707
Fax(616) 363-0390
Sole ProprietorNo
Enumeration DateMay 13, 2006
Last NPPES UpdateJuly 13, 20262 updates tracked since enumeration
NPPES CertifiedSeptember 2, 2020
✔ NPI 1720039878 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in MI · 13162
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.
4829 E BELTLINE AVE NE, Grand Rapids, MI 49525
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Other Identifiers 1

Medicaid4066190MI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

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. Bruce Arden Jackson Ii Dds 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 49525 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
$84.74 typical visit price
range $54.34 – $166.68
Typical copayment $21.18 (range $13.58 – $41.67)
Most-billed visit code 99203
Established Patient
$68.07 typical visit price
range $17.09 – $135.40
Typical copayment $17.01 (range $4.27 – $33.85)
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 20

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

CASSANDRA FAYE PATTERSON LPC
Counselor
4829 E BELTLINE AVE NE, BUILDING 3, STE 303
GRAND RAPIDS, MI 49525
Kent County (616) 202-2762
DR. RHETT BAYLOR JACKSON D.D.S
Dentist (General Practice)
4829 E BELTLINE AVE NE
GRAND RAPIDS, MI 49525
Kent County (616) 550-0087
MITUS-ROSENDALL D.D.S.
Dentist (General Practice)
4829 E BELTLINE AVE NE
GRAND RAPIDS, MI 49525
Kent County (616) 363-9277
JONATHAN MULDER
Counselor (Professional)
4829 E BELTLINE AVE NE, SUITE 103
GRAND RAPIDS, MI 49525
Kent County (616) 734-9417
SUSAN MISSAD COUNSELING
Psychologist (Counseling)
4829 E BELTLINE AVE NE
GRAND RAPIDS, MI 49525
Kent County (616) 291-6595
SOULCARE COUNSELING
Social Worker (Clinical)
4829 E BELTLINE AVE NE, SUITE 103
GRAND RAPIDS, MI 49525
Kent County (616) 560-4036
DR. ALAN LOUIS ROSENDALL D.D.S.
Dentist (General Practice)
4829 E BELTLINE AVE NE
GRAND RAPIDS, MI 49525
Kent County (616) 363-9277
FAMILIES FOREVER COUNSELING PLC
Community/Behavioral Health
4829 E BELTLINE AVE NE, SUITE #103
GRAND RAPIDS, MI 49525
Kent County (616) 217-8621

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 Bruce Jackson's NPI number?

The NPI number for Bruce Jackson is 1720039878. It was assigned to this individual provider in the NPPES registry on May 13, 2006.

Where is Bruce Jackson located?

Bruce Jackson practices at 4829 E Beltline Ave NE, Grand Rapids, MI 49525. The listed phone number is (616) 363-8707.

What is Bruce Jackson's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Bruce Jackson enrolled in Medicare?

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

What insurance does Bruce Jackson accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Cross Blue Shield of Michigan Mutual Insurance Company and Blue Cross and Blue Shield of Alabama and 8 other insurers list Bruce Jackson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Bruce Jackson was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 days 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.