Jackson Derrick, DMD

Dentist · Abingdon, VA

Individual Active NPI

NPI number 1245171776

Practice location

616 Campus Dr Ste 100
Abingdon, VA 24210-9706
Phone
(276) 525-4487

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NPI record

NPI
1245171776
Entity type
Individual (Type 1)
Enumeration date
April 1, 2026
Last updated
June 29, 2026
Certified
June 29, 2026
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Dentist Primary 122300000X 0401420083 VA

Mailing address

225 Mallard Dr
Chapin, SC 29036-8265

About Dr. Derrick

Jackson Derrick, DMD is a healthcare provider registered in the NPI registry with the primary taxonomy Dentist (code 122300000X). The practice location is 616 Campus Dr Ste 100, Abingdon, VA 24210-9706. The NPI number 1245171776 was assigned on April 1, 2026 and the record was last updated on June 29, 2026.

Dr. Derrick lists a license in the registry: #0401420083 (VA) 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 Jackson Derrick, DMD?

The NPI number is 1245171776.

What is the phone number of Dr. Derrick?

The phone number listed for the practice location is (276) 525-4487.

Where is Dr. Derrick located?

616 Campus Dr Ste 100, Abingdon, VA 24210-9706.

What is the taxonomy code for Dr. Derrick?

The primary taxonomy code is 122300000X – Dentist.

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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