DR. JORDAN N JACKSON DDS
NPI 1790396802
Dentist - General Practice in Philadelphia, PA

Q: What is Jordan Jackson's NPI number?

The NPI number for Jordan Jackson is 1790396802. It was assigned to this individual provider in the NPPES registry on August 12, 2020.

Q: What is Jordan Jackson's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Jordan Jackson was last updated on June 22, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months 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 August 12, 2020

5501 OLD YORK RD, PHILADELPHIA, PA 19141(215) 456-7130 Get Directions Write a Review

NPPES record last updated: June 22, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 22, 2025, Aug 12, 2020 (2 updates tracked since 2020).

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About Dr. Jordan N Jackson Dds NPPES

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

DR. JORDAN N JACKSON DDS (NPI 1790396802) is an individual general practice provider in Philadelphia, Pennsylvania, licensed in Maryland (17020) and active in the NPI registry since August 2020.

NPPES Registry Identity

NPI1790396802

Entity TypeIndividualMale

Primary Taxonomy1223G0001X

Provider Legal NameDR. JORDAN N JACKSONCredential: DDS

Location Address5501 OLD YORK RDPhiladelphia, PA 19141-3018

Mailing Address5501 Old York RdPhiladelphia, PA 19141-3018 · (215) 456-7130

Phone(215) 456-7130

Sole ProprietorNo

Enumeration DateAugust 12, 2020

Last NPPES UpdateJune 22, 20252 updates tracked since enumeration

NPPES CertifiedJune 22, 2025

✔ NPI 1790396802 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

License✔ Licensed in MD · 17020

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.

5501 OLD YORK RD, Philadelphia, PA 19141

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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.

KENNETH KLECKNER MD

Emergency Medicine

5501 OLD YORK RD, EINSTEIN MEDICAL CENTER - PHILADELPHIA
PHILADELPHIA, PA 19141

Philadelphia County (215) 456-6679

MS. AMMAN HASSAN MD

Pediatrics

5501 OLD YORK RD
PHILADELPHIA, PA 19141

Philadelphia County (215) 456-3810

TAYLOR NICOLE THOMPSON PA-C

Physician Assistant (Medical)

5501 OLD YORK RD, KORMAN BUILDING SUITE 202
PHILADELPHIA, PA 19141

Philadelphia County (215) 254-2630

STEPHEN RYAN CHEN

Orthopaedic Surgery

5501 OLD YORK RD
PHILADELPHIA, PA 19141

Philadelphia County (215) 456-7890

DR. DHRUV SHARMA MD

Student in an Organized Health Care Education/Training Program

5501 OLD YORK RD
PHILADELPHIA, PA 19141

Philadelphia County (215) 456-7890

TIMOTHY DANIEL GARDNER DO

Student in an Organized Health Care Education/Training Program

5501 OLD YORK RD
PHILADELPHIA, PA 19141

Philadelphia County (215) 456-7890

DR. JONATHAN THOMAS LUCIANI DO

Student in an Organized Health Care Education/Training Program

5501 OLD YORK RD
PHILADELPHIA, PA 19141

Philadelphia County (215) 456-7890

ASHIKA KAPOOR MD

Psychiatry & Neurology (Psychiatry)

5501 OLD YORK RD
PHILA, PA 19141

Philadelphia County (215) 456-8103

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 Jordan Jackson's NPI number?

The NPI number for Jordan Jackson is 1790396802. It was assigned to this individual provider in the NPPES registry on August 12, 2020.

Where is Jordan Jackson located?

Jordan Jackson practices at 5501 Old York Rd, Philadelphia, PA 19141. The listed phone number is (215) 456-7130.

What is Jordan Jackson's specialty?

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

When was this NPI record last updated?

The NPPES record for Jordan Jackson was last updated on June 22, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months 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.