Christopher R. Jackson

Dentist · Odessa, TX

Individual Active NPI

NPI number 1003478629

Practice location

3930 Tanglewood Ln
Odessa, TX 79762-7165
Phone
(432) 366-0896

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NPI record

NPI
1003478629
Entity type
Individual (Type 1)
Enumeration date
July 3, 2019
Last updated
January 18, 2025
Certified
January 18, 2025
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Dentist Primary 122300000X 36092 TX
Dentist 122300000X D-5055 ID

Mailing address

1501 W Wall St
Midland, TX 79701-6525

About Christopher Jackson

Christopher R. Jackson is a healthcare provider registered in the NPI registry with the primary taxonomy Dentist (code 122300000X). The practice location is 3930 Tanglewood Ln, Odessa, TX 79762-7165. The NPI number 1003478629 was assigned on July 3, 2019 and the record was last updated on January 18, 2025.

Christopher Jackson lists 2 licenses in the registry: #36092 (TX) for Dentist; #D-5055 (ID) for Dentist. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Christopher R. Jackson?

The NPI number is 1003478629.

What is the phone number of Christopher Jackson?

The phone number listed for the practice location is (432) 366-0896.

Where is Christopher Jackson located?

3930 Tanglewood Ln, Odessa, TX 79762-7165.

What is the taxonomy code for Christopher Jackson?

The primary taxonomy code is 122300000X – Dentist; 1 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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