DR. KYLE R. JACKSON (NPI# 1730159849) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730159849 |
| Entity Type | Individual |
| Full Name | DR. KYLE R. JACKSON |
| Credential | DDS |
| Practice Address |
273 Regency Ridge Dr Centerville OH 45459-4221 |
| Practice Telephone | 9375867729 |
| Practice Fax Number | 9376604450 |
| Mailing Telephone | 9375867729 |
| Mailing Fax Number | 9376604450 |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2016-12-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
30-01-8976 | OH | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821247388 | Kyle B Jackson | Counselor | 1759 Riverview St, Eugene, OR 97403-3104 | 2008-09-09 |
| 1861597908 | Kyle Jackson | Physical Therapist | 1310 Casa Grande Rd, Suite B, Petaluma, CA 94954-5603 | 2006-09-13 |
| 1669085718 | Kyle Sebastian Jackson | Chiropractor | 12620 Beach Blvd Ste 6, Jacksonville, FL 32246-7130 | 2020-08-28 |
| 1275018384 | Kyle Lamet Jackson | Marriage & Family Therapist | 744 Empire St, Fairfield, CA 94533-5562 | 2018-09-25 |
| 1164849352 | Kyle Jackson | Student in an Organized Health Care Education/Training Program | 600 N Wolfe St Tower 110, The Johns Hopkins Hospital, Baltimore, MD 21287-2109 | 2014-03-25 |
| 1548569056 | Kyle Jefferson Jackson | Internal Medicine | 619 S Fleishel Ave, Suite 327, Tyler, TX 75701-2004 | 2011-03-23 |
| 1922334754 | Kyle Spencer Jackson | Dentist | 301 Saddle Dr, Suite A, Helena, MT 59601-8098 | 2009-10-29 |
| 1194967604 | Kyle William Jackson | Pediatrics | 705 Riley Hospital Dr, Roc 4340, Indianapolis, IN 46202-5109 | 2009-03-30 |
| 1104007301 | Kyle Robert Jackson | Physician Assistant | 1307 Federal St Ste 2, Pittsburgh, PA 15212-4769 | 2007-11-16 |
| 1942251731 | Kyle E. Jackson | Anesthesiology | 3625 N Elm St, Suite 110a, Greensboro, NC 27455-2604 | 2006-05-15 |
| Street Address |
273 REGENCY RIDGE DR |
| City | CENTERVILLE |
| State | OH |
| Zip Code | 45459-4221 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710364369 | Adventure Pediatric Dentistry of Centerville - Drs. Jackson and Mason | Dentist | 273 Regency Ridge Dr, Centerville, OH 45459-4221 | 2015-05-04 |
| 1386073112 | Centerille Pediatric Dentistry, Kyle R Jackson, Dds, Inc | Dentist | 273 Regency Ridge Dr, Centerville, OH 45459-4221 | 2013-11-02 |
| 1609075126 | Kashif Bhatti | Dentist | 273 Regency Ridge Dr, Centerville, OH 45459 | 2007-07-13 |
| 1114994068 | Barbara Baughman Cortez | Dermatology | 273 Regency Ridge Dr, Centerville, OH 45459-4221 | 2006-02-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659917466 | Sarai Burke Robinson | Occupational Therapist | 2200 Miami Valley Rd, Dayton, OH 45459 | 2019-11-27 |
| 1689179855 | Paragon Infusion Therapy, LLC | Durable Medical Equipment & Medical Supplies | 1746 Thomas Paine Pkwy, Centerville, OH 45459 | 2018-03-28 |
| 1922555473 | Hannah Gualtieri | Specialist/Technologist | Miami Valley Drive, Suite 320, Centerville, OH 45459 | 2016-09-01 |
| 1326410028 | Kathleen E Dorsten | Counselor | 37 Irongate Park Dr, Centerville, OH 45459 | 2015-10-21 |
| 1184000846 | Valeriya Falkenshtern | Specialist/Technologist | 2400 Miami Valley Drive, Newborn Hearing Screens, Dayton, OH 45459 | 2015-08-05 |
| 1700169331 | Monica Lynn Carrico | Registered Nurse | 7625 Paragon Road Suite C, Dayton, OH 45459 | 2011-09-20 |
| 1427360080 | Tonia S Campbell | Physical Therapist | 1235 E. Alex Bell Road, Centerville, OH 45459 | 2010-07-11 |
| 1265768956 | Health At Home, LLC | Home Health | 6443 Bethany Village Drive, Dayton, OH 45459 | 2009-10-30 |
| 1881826337 | Annetta Jean Davis | Social Worker | 7950 Clyo Road, Centerville, OH 45459 | 2009-08-18 |
| 1740459783 | Ryan A Long | Dentist | 2591 Miamisburg-centerville Rd, Suite 200, Dayton, OH 45459 | 2008-02-25 |
| Find all providers in zip 45459 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| 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. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548788631 | Betty Tucker, D.d.s., LLC | Dentist | 6438 Wilmington Pike Ste 205, Centerville, OH 45459-7023 | 2017-09-08 |
| 1710364369 | Adventure Pediatric Dentistry of Centerville - Drs. Jackson and Mason | Dentist | 273 Regency Ridge Dr, Centerville, OH 45459-4221 | 2015-05-04 |
| 1386073112 | Centerille Pediatric Dentistry, Kyle R Jackson, Dds, Inc | Dentist | 273 Regency Ridge Dr, Centerville, OH 45459-4221 | 2013-11-02 |
| 1609075126 | Kashif Bhatti | Dentist | 273 Regency Ridge Dr, Centerville, OH 45459 | 2007-07-13 |
| 1598898926 | Patrick A Falco | Dentist | 1645 Falmouth Rd, Centerville, MA 02632-2932 | 2007-03-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255931911 | Rachel I Rosen, Dds LLC | Dentist | 9964 Vail Dr Ste 1, Twinsburg, OH 44087-2972 | 2020-10-30 |
| 1861014334 | Page Pediatric Dentistry | Dentist | 5699 Innovation Dr, Dublin, OH 43016-3312 | 2020-05-07 |
| 1629602412 | Tuka N/a Sada | Dentist | 9601 Chester Ave Rm 284-h, Cleveland, OH 44106-1666 | 2020-03-02 |
| 1992336093 | Al Saad Dental LLC | Dentist | 7250 Center St Ste C, Mentor, OH 44060-4920 | 2020-01-28 |
| 1912547811 | Cincy Pediatric Dentistry, LLC | Dentist | 1131 Cryer Ave, Cincinnati, OH 45208 | 2020-01-09 |
| 1790338168 | Corbin Salthouse | Dentist | 13390 Cedar Rd, Cleveland Heights, OH 44118-2955 | 2019-07-24 |
| 1588223929 | Amber Sun | Dentist | 11100 Euclid Ave # Rb&c1200, Cleveland, OH 44106-1716 | 2019-06-10 |
| 1710546437 | Kyle R. Jackson, Dds, LLC | Dentist | 4090 Indian Ripple Rd Unit 102, Beavercreek, OH 45440-3253 | 2019-06-06 |
| 1932764107 | Cuadra Pediatric Dentistry, LLC | Dentist | Cuadra Pediatric Dentistry, LLC, 486 Wentz Street, Tiffin, OH 44883 | 2019-05-03 |
| 1265901136 | Ohio Dental Team LLC | Dentist | 7690 First Place, Bldg D, Suite E, Oakwood, OH 44146 | 2018-11-20 |
| Find all providers with the same taxonomy | ||||
| City | CENTERVILLE |
| Zip Code | 45459 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.