Kelly Donald Jackson, DDS

Dentist · Largo, FL

Individual Active NPI

NPI number 1518982487

Practice location

1571 Jonathan Ct
Largo, FL 33770-1676
Phone
(810) 434-7192

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NPI record

NPI
1518982487
Entity type
Individual (Type 1)
Enumeration date
July 13, 2006
Last updated
December 9, 2024
Certified
December 6, 2024
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Dentist Primary 122300000X DN24739 FL
Dentist 122300000X 14202 MI

About Dr. Jackson

Kelly Donald Jackson, DDS is a healthcare provider registered in the NPI registry with the primary taxonomy Dentist (code 122300000X). The practice location is 1571 Jonathan Ct, Largo, FL 33770-1676. The NPI number 1518982487 was assigned on July 13, 2006 and the record was last updated on December 9, 2024.

Dr. Jackson lists 2 licenses in the registry: #DN24739 (FL) for Dentist; #14202 (MI) 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 Kelly Donald Jackson, DDS?

The NPI number is 1518982487.

What is the phone number of Dr. Jackson?

The phone number listed for the practice location is (810) 434-7192.

Where is Dr. Jackson located?

1571 Jonathan Ct, Largo, FL 33770-1676.

What is the taxonomy code for Dr. 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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