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Deactivated NPI 1477637833 Deactivated / Inactive NPI Male Practitioner

Dr. Gregory Thurgood Jackson , DDS

Dentist - General Practice • Carson, CA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Gregory Jackson has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date October 24, 2006
NPI Deactivation Date March 24, 2023
Total Practice Duration ~17 Years of Practice (2006 – 2023)

Professional Overview & Biography Verified Profile Summary

Dr. Gregory Jackson, DDS was a registered Dentist - General Practice practicing in Carson, CA. Throughout an active medical career spanning 17 years, Dr. Jackson provided care at the practice location at 550 E DEL AMO BLVD until profile deactivation on 2023-03-24.

Practice Location & Contact Primary Location

Practice Address

550 E Del Amo Blvd

Carson, CA 907463314

Telephone 3105155672
Fax 3103526208
Associated Practice Facility / Clinic
🏢 Community Dental Services Facility NPI 1811068786

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Carson, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 21.7 Yrs
Regional Practice Density
28 Specialists

Practicing in Carson, CA (18734 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License CA 30533

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

5 Associated Practitioners
Fariba Matinfar

Dentist - Periodontics

NPI 1073602157
Dr. Christina Duong , DDS

Dentist - General Practice

NPI 1417471871

Doctor of Dental Surgery

Dr. Julian Miller , DDS

Dentist - General Practice

NPI 1487658001

Doctor of Dental Surgery

Dr. Morris Ghermezi , DDS

Dentist - Oral and Maxillofacial Surgery

NPI 1568917110

Doctor of Dental Surgery

Dr. Abbas Hariri , DDS

Dentist - General Practice

NPI 1780753954

Doctor of Dental Surgery

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated March 24, 2023

Record deactivated on March 24, 2023

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 550 E DEL AMO BLVD, CARSON, CA 907463314 (Tel: 3105155672)

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Updated Business Mailing Address July 08, 2007

Registered at 827 S BURNSIDE AVE, LOS ANGELES, CA 900364744 (Tel: 3239357991)

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Provider Name / Credentials Updated July 08, 2007

Recorded as GREGORY JACKSON, DDS

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist (License #30533 in CA)

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Initial NPI Registration & Enumeration October 24, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1477637833
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 24, 2006
Last Update: July 08, 2007
Deactivation Date: March 24, 2023

Mailing Address

827 S Burnside Ave

Los Angeles, CA 900364744

Phone: 3239357991

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.