JACKSON PEDIATRIC DENTISTRY PC NPI 1255870051

NPI Information

  • NPI: 1255870051
  • Provider Name: JACKSON PEDIATRIC DENTISTRY PC
  • Classification: Dentist - 1223P0221X
  • Specialization: Pediatric Dentistry
  • Entity Type: Organization
  • Address: 2500 SPRING ARBOR RD
    JACKSON, MI
    ZIP 49203
  • Phone: (517) 787-1022

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NPI Details

JACKSON PEDIATRIC DENTISTRY PC is a pediatric dentistry dentist in Jackson, MI. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. JACKSON PEDIATRIC DENTISTRY PC NPI is 1255870051. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2500 SPRING ARBOR RD
JACKSON, MI
ZIP 49203-602
Phone: (517) 787-1022

The provider's authorized official is Steven L Davenport .
The authorized official title is Owner and has the following contact phone number (517) 787-1022.

The enumeration date for this NPI number is 2/14/2017 and was last updated on 2/14/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223P0221XDentistPediatric Dentistry2901017187MICHIGANYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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