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SCOTT JACKS DDS INC NPI 1366549545


NPI Information

NPI: 1366549545
Provider Name: SCOTT JACKS DDS INC

Doing Business As: CHILDREN'S DENTAL GROUP

Classification: Dentist - 122300000X
Entity Type: Organization
Address:
4444 TWEEDY BLVD
SOUTH GATE, CA
ZIP 90280
Phone: (323) 564-2444
Get Directions

SCOTT JACKS DDS INC is a dentist in South Gate, CA. The provider is a dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. SCOTT JACKS DDS INC NPI is 1366549545. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Children's Dental Group.

The provider's business location address is:

4444 TWEEDY BLVD
SOUTH GATE, CA
ZIP 90280-304
Phone: (323) 564-2444
Fax: (564) 249-7565

The provider's authorized official is Jerry David Minsky .
The authorized official title is Owner and has the following contact phone number (323) 564-2444.

The enumeration date for this NPI number is 9/20/2006 and was last updated on 9/23/2015.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223E0200XDentistEndodontics31668CALIFORNIANo
21223P0221XDentistPediatric Dentistry31668CALIFORNIANo
31223P0300XDentistPeriodontics31668CALIFORNIANo
41223S0112XDentistOral and Maxillofacial Surgery31668CALIFORNIANo
51223X0400XDentistOrthodontics and Dentofacial Orthopedics31668CALIFORNIANo
6122300000XDentist31668ARIZONAYes

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

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