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DR. DENNIS W. JACKSON D.D.S.
NPI 1881999761
Dentist in Edgewood, NM

Active since January 24, 2011PECOS Enrolled
164 SQUARE H RD, EDGEWOOD, NM 87015(505) 610-7885 Get Directions Write a Review

NPPES record last updated: January 24, 2011. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. Dennis W. Jackson D.d.s. NPPES

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

DR. DENNIS W. JACKSON D.D.S. (NPI 1881999761) is an individual dentist in Edgewood, New Mexico, licensed in New Mexico (DD2699) and active in the NPI registry since January 2011. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1881999761
Entity TypeIndividualMale
Primary Taxonomy122300000X
Provider Legal NameDR. DENNIS W. JACKSONCredential: D.D.S.
Location Address164 SQUARE H RDEdgewood, NM 87015-9538
Mailing Address164 Square H RdEdgewood, NM 87015-9538 · (505) 610-7885
Phone(505) 610-7885
Sole ProprietorYes
Enumeration DateJanuary 24, 2011
✔ NPI 1881999761 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in NM · DD2699
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.
164 SQUARE H RD, Edgewood, NM 87015
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Dennis W. Jackson D.d.s. 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.

Medicare Billing Reassignment

Medicare enrollment records show Dennis Jackson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Kewa Pueblo Health Corporation
38 mi
Federally Qualified Health Center (FQHC)
85 W HIGHWAY 22
Santo Domingo Pueblo, NM 87052
  • Reassigned Medicare billing, Texas enrollment
  • 52 clinicians in this Medicare group
NPI 1467739888 (505) 465-3060

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 87015 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
$84.79 typical visit price
range $54.26 – $166.80
Typical copayment $21.19 (range $13.56 – $41.70)
Most-billed visit code 99203
Established Patient
$68.00 typical visit price
range $17.00 – $135.35
Typical copayment $17.00 (range $4.25 – $33.83)
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.

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 Dennis Jackson's NPI number?

The NPI number for Dennis Jackson is 1881999761. It was assigned to this individual provider in the NPPES registry on January 24, 2011.

Where is Dennis Jackson located?

Dennis Jackson practices at 164 Square H Rd, Edgewood, NM 87015. The listed phone number is (505) 610-7885.

What is Dennis Jackson's specialty?

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

Is Dennis Jackson enrolled in Medicare?

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

Which organization bills Medicare for Dennis Jackson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Dennis Jackson reassigns Medicare benefits to Kewa Pueblo Health Corporation (Santo Domingo Pueblo, NM). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Dennis Jackson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Dennis Jackson was last updated on January 24, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.