Dr. Dawn A Jackson-Breeden, DMD
Dentist, General Practice in Benton, IL. Individual provider (NPI-1).
NPI number1245307024
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1245307024
- Entity type
- Individual (NPI-1)
- Name
- Dr. Dawn A Jackson-Breeden
- Credential
- DMD
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Nov 29, 2006
- Last updated
- Jul 8, 2007
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · ORDER AND REFERRING ONLY - DENTIST
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility No · Hospice Yes
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 019022846 | IL | Yes |
Practice location
405 E Park StBenton, IL 62812-1971
Phone 618-439-4391 · Fax 618-439-7410
Mailing address
405 E Park StBenton, IL 62812-1971
Phone 618-439-4391 · Fax 618-439-7410
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Other General Practice Dentistry providers in Benton, IL
Checking a whole list?
Paste a list of NPIs and get status, record, Medicare enrollment and OIG exclusion for each one. 100 free a day, then from $5 for 5,000. Useful for credentialing, billing and pharmacy claim checks.