PEDIATRIC DENTISTRY AND ORTHODONTICS OF JACKSON
NPI 1952058133
Dentist - Pediatric Dentistry in Jackson, MI

Q: What is Pediatric Dentistry And Orthodontics Of Jackson's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Pediatric Dentistry, with taxonomy code 1223P0221X.

Active since March 07, 2022

900 E MICHIGAN AVE STE 100, JACKSON, MI 49201(517) 376-3142 Get Directions Write a Review

NPPES record last updated: March 7, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Pediatric Dentistry And Orthodontics Of Jackson NPPES

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

PEDIATRIC DENTISTRY AND ORTHODONTICS OF JACKSON (NPI 1952058133) is a healthcare organization registered as a pediatric dentistry in Jackson, Michigan and active in the NPI registry since March 2022. The organization lists Ly Julie Van, Pediatric Dentist, as its authorized official.

NPPES Registry Identity

NPI1952058133

Entity TypeOrganization

Primary Taxonomy1223P0221X

Legal Business NamePEDIATRIC DENTISTRY AND ORTHODONTICS OF JACKSON

Location Address900 E MICHIGAN AVE STE 100Jackson, MI 49201-2457

Mailing Address900 E Michigan Ave Ste 100Jackson, MI 49201-2457 · (517) 376-3142

Phone(517) 376-3142

Organization SubpartNo

Authorized OfficialLy Julie VanPediatric Dentist · (586) 744-9869

Enumeration DateMarch 7, 2022

NPPES CertifiedMarch 7, 2022

✔ NPI 1952058133 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers

Taxonomy Code1223P0221X

Definition

An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.

Also ListedDentist · Orthodontics and Dentofacial OrthopedicsTaxonomy 1223X0400X

900 E MICHIGAN AVE STE 100, Jackson, MI 49201

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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of Michigan Mutual Insurance Company, UnitedHealthcare.Insurance ›

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 Pediatric Dentistry And Orthodontics Of Jackson's NPI number?

The NPI number for Pediatric Dentistry And Orthodontics Of Jackson is 1952058133. It was assigned to this organization in the NPPES registry on March 7, 2022.

Where is Pediatric Dentistry And Orthodontics Of Jackson located?

Pediatric Dentistry And Orthodontics Of Jackson is located at 900 E Michigan Ave Ste 100, Jackson, MI 49201. The listed phone number is (517) 376-3142.

What is Pediatric Dentistry And Orthodontics Of Jackson's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Pediatric Dentistry, with taxonomy code 1223P0221X.

What insurance does Pediatric Dentistry And Orthodontics Of Jackson accept?

Health plans from Blue Cross Blue Shield of Michigan Mutual Insurance Company and UnitedHealthcare list Pediatric Dentistry And Orthodontics Of 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 Pediatric Dentistry And Orthodontics Of Jackson was last updated on March 7, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.