CHARLES RUSSELL JACKSON DDS NPI 1306929856

NPI Information

NPI: 1306929856
Provider Name: CHARLES RUSSELL JACKSON, DDS
Classification: Dentist - 1223E0200X
Entity Type: Individual

Specialization: Endodontics

Address:
1 MED CENTER DIRVE
MORGANTOWN, WV
ZIP 26506
Phone: (304) 293-2240
Get Directions

Charles Russell Jackson, DDS is an endodontics dentist in Morgantown, WV. The provider is the branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. Charles Russell Jackson, DDS NPI is 1306929856. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1 MED CENTER DIRVE
MORGANTOWN, WV
ZIP 26506
Phone: (304) 293-2240

The enumeration date for this NPI number is 10/20/2006 and was last updated on 7/8/2007.

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
1	1223E0200X	Dentist	Endodontics	2122	WEST VIRGINIA	Yes

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: 4/28/2024

NPI Synchronization or Removal

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