MR. RON DARRYL JACKSON DDS
NPI 1871586990
Dentist in Saint Louis, MO

Q: What is Ron Jackson's NPI number?

The NPI number for Ron Jackson is 1871586990. It was assigned to this individual provider in the NPPES registry on August 24, 2005.

Q: What is Ron Jackson'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 Ron Jackson was last updated on June 17, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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 August 24, 2005

5471 DR MARTIN LUTHER KING DR, SAINT LOUIS, MO 63112(314) 367-5820(314) 367-7010 Get Directions Write a Review

NPPES record last updated: June 17, 2010. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Mr. Ron Darryl Jackson Dds NPPES

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

MR. RON DARRYL JACKSON DDS (NPI 1871586990) is an individual dentist in Saint Louis, Missouri, licensed in Missouri (012608) and active in the NPI registry since August 2005.

NPPES Registry Identity

NPI1871586990

Entity TypeIndividualMale

Primary Taxonomy122300000X

Provider Legal NameMR. RON DARRYL JACKSONCredential: DDS

Location Address5471 DR MARTIN LUTHER KING DRSaint Louis, MO 63112-4265

Mailing Address4211 Maryland AveSt. Louis, MO 63108 · (314) 367-5820 · Fax (314) 367-7010

Phone(314) 367-5820

Fax(314) 367-7010

Sole ProprietorNo

Enumeration DateAugust 24, 2005

Last NPPES UpdateJune 17, 2010

✔ NPI 1871586990 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

License✔ Licensed in MO · 012608

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.

5471 DR MARTIN LUTHER KING DR, Saint Louis, MO 63112

Open in Google Maps ↗

Other Identifiers 4

Medicaid403231038MO

Medicaid403231020MO

Medicare UPINU54192

Medicare ID-Type Unspecified232701200MO

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas.Insurance ›

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.

MS. CARLA DAUGHERTY DDS

Dentist

5471 DR MARTIN LUTHER KING DR
ST LOUIS, MO 63112

St. Louis City (314) 367-5820

MRS. JETUAN L ROWLEY-HERRON M.D.

Family Medicine

5471 DR MARTIN LUTHER KING DR
SAINT LOUIS, MO 63112

St. Louis City (314) 367-5820

MRS. ANDREA LASHELLE BRUCE LPN

Licensed Practical Nurse

5471 DR MARTIN LUTHER KING DR
ST LOUIS, MO 63112

St. Louis City (314) 367-5820

MRS. TERESITA AGUSTIN COMETA MD

Family Medicine

5471 DR MARTIN LUTHER KING DR
SAINT LOUIS, MO 63112

St. Louis City (314) 367-5820

DR. LAILA G. GABRAWY M.D.

Ophthalmology

5471 DR MARTIN LUTHER KING DR
SAINT LOUIS, MO 63112

St. Louis City (314) 367-5820

RODELYNN RICHEE LPN

Licensed Practical Nurse

5471 DR MARTIN LUTHER KING DR
SAINT LOUIS, MO 63112

St. Louis City (314) 367-5820

MRS. PAMELA LATONIA MARSHALL RPH

Pharmacist

5471 DR MARTIN LUTHER KING DR
SAINT LOUIS, MO 63112

St. Louis City (314) 367-5820

MRS. MARGARET CHINYERE NWAOBASI RN MSN

Registered Nurse

5471 DR MARTIN LUTHER KING DR
SAINT LOUIS, MO 63112

St. Louis City (314) 367-5820

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 Ron Jackson's NPI number?

The NPI number for Ron Jackson is 1871586990. It was assigned to this individual provider in the NPPES registry on August 24, 2005.

Where is Ron Jackson located?

Ron Jackson practices at 5471 Dr Martin Luther King Dr, Saint Louis, MO 63112. The listed phone number is (314) 367-5820.

What is Ron Jackson's specialty?

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

What insurance does Ron Jackson accept?

Health plans from Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas list Ron 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 Ron Jackson was last updated on June 17, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.