JACKSON PEDIATRIC DENTISTRY OF SUMMERVILLE
NPI 1962981142
Dentist - Pediatric Dentistry in Summerville, SC

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

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

Active since August 09, 2018

405 WEST 4TH STREET NORTH, SUMMERVILLE, SC 29483(843) 376-3161 Get Directions Write a Review

NPPES record last updated: August 9, 2018. Verified against the NPPES registry weekly; last sync: August 30, 2026.

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About Jackson Pediatric Dentistry Of Summerville NPPES

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

JACKSON PEDIATRIC DENTISTRY OF SUMMERVILLE (NPI 1962981142) is a healthcare organization registered as a pediatric dentistry in Summerville, South Carolina and active in the NPI registry since August 2018. The organization lists Jeffrey Jackson, Owner, as its authorized official.

NPPES Registry Identity

NPI1962981142

Entity TypeOrganization

Primary Taxonomy1223P0221X

Legal Business NameJACKSON PEDIATRIC DENTISTRY OF SUMMERVILLE

Location Address405 WEST 4TH STREET NORTHSummerville, SC 29483

Mailing Address303 Branch Creek TrlSummerville, SC 29483-5338 · (910) 620-7881

Phone(843) 376-3161

Organization SubpartNo

Authorized OfficialJeffrey JacksonOwner · (910) 620-7881

Enumeration DateAugust 9, 2018

✔ NPI 1962981142 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers

Taxonomy Code1223P0221X

License✔ Licensed in SC · 911

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.

405 WEST 4TH STREET NORTH, Summerville, SC 29483

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Other Identifiers 1

MedicaidZX8666SC

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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 Jackson Pediatric Dentistry Of Summerville's NPI number?

The NPI number for Jackson Pediatric Dentistry Of Summerville is 1962981142. It was assigned to this organization in the NPPES registry on August 9, 2018.

Where is Jackson Pediatric Dentistry Of Summerville located?

Jackson Pediatric Dentistry Of Summerville is located at 405 West 4th Street North, Summerville, SC 29483. The listed phone number is (843) 376-3161.

What is Jackson Pediatric Dentistry Of Summerville's specialty?

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

When was this NPI record last updated?

The NPPES record for Jackson Pediatric Dentistry Of Summerville was last updated on August 9, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.