Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1871586990 Individual Practitioner Male Practitioner

Dr. Ron Darryl Jackson , DDS

Dentist • Saint Louis, MO

Professional Overview & Biography Verified Profile Summary

Dr. Ron Jackson, DDS is a registered healthcare professional specializing in Dentist in Saint Louis, MO. Practice services are available at 5471 DR MARTIN LUTHER KING DR under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

5471 Dr Martin Luther King Dr

Saint Louis, MO 631124265

Telephone 3143675820
Fax 3143677010
Associated Practice Facility / Clinic
🏢 Carestl Health #1 Facility NPI 1972653202

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Saint Louis, MO

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 7.0 Yrs
State Avg: 9.6 Yrs
Regional Practice Density
230 Specialists

Practicing in Saint Louis, MO (1740 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 Primary Specialty

NUCC Taxonomy Code: 122300000X

State License MO 012608

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.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
403231020 (MO)
Medicaid State Provider ID
403231038 (MO)

Practice Associates & Co-Workers

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

40 Associated Practitioners
NPI 1003874066

Doctor of Dental Surgery

NPI 1003893785

Doctor of Medicine (M.D.)

Andrea Bruce , LPN

Licensed Practical Nurse

NPI 1013011741

Licensed Practical Nurse

NPI 1013918481

Doctor of Medicine (M.D.)

NPI 1013933415

Doctor of Medicine (M.D.)

Rodelynn Richee , LPN

Licensed Practical Nurse

NPI 1033574504

Licensed Practical Nurse

Career & Practice History Timeline

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

6 Historical Events
NPI Profile Active June 17, 2010

NPI status registered as active in NPPES database

📍
Updated Practice Location June 17, 2010

Registered at 5471 DR MARTIN LUTHER KING DR, SAINT LOUIS, MO 631124265 (Tel: 3143675820)

📍
Updated Business Mailing Address June 17, 2010

Registered at 4211 MARYLAND AVE, ST. LOUIS, MO 63108 (Tel: 3143675820)

👤
Provider Name / Credentials Updated June 17, 2010

Recorded as RON JACKSON, DDS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 17, 2010

Dentist (License #012608 in MO)

🟢
Initial NPI Registration & Enumeration August 24, 2005

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: 1871586990
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 24, 2005
Last Update: June 17, 2010
Sole Proprietor: No

Mailing Address

4211 Maryland Ave

St. Louis, MO 63108

Phone: 3143675820

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.