Dr. Robert E Jackson, D.D.S.
Dentist in Carrollton, TX. Individual provider (NPI-1).
NPI number1528075355
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1528075355
- Entity type
- Individual (NPI-1)
- Name
- Dr. Robert E Jackson
- Credential
- D.D.S.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Aug 2, 2006
- Last updated
- Jul 8, 2007
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- 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 |
|---|---|---|---|---|
| 122300000X | Dentist | 18030 | TX | Yes |
Practice location
1012 W Hebron Pkwy Ste 108Carrollton, TX 75010-1123
Phone 972-492-1064 · Fax 972-492-2483
Mailing address
1012 W Hebron Pkwy Ste 108Carrollton, TX 75010-1123
Phone 972-492-1064 · Fax 972-492-2483
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.
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