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Deactivated NPI 1598989030 Deactivated / Inactive NPI Male Practitioner

Dr. Robert Charles Jackson , DDS

Dentist • Earlville, NY

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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. Robert Jackson has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date April 13, 2007
NPI Deactivation Date June 25, 2026
Total Practice Duration ~19 Years of Practice (2007 – 2026)

Professional Overview & Biography Verified Profile Summary

Dr. Robert Jackson, DDS was a registered Dentist practicing in Earlville, NY. Throughout an active medical career spanning 19 years, Dr. Jackson provided care at the practice location at 59 N MAIN ST until profile deactivation on 2026-06-25.

Practice Location & Contact Primary Location

Practice Address

59 N Main St

Earlville, NY 13332

Telephone 3156916502
Fax 3156913119
Associated Practice Facility / Clinic
🏢 Robert C Jackson Ii D.d.s. Pc Facility NPI 1760861421

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Earlville, NY

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 24.5 Yrs
Regional Practice Density
1 Specialists

Practicing in Earlville, NY (6355 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 NY 038574

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.

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 June 25, 2026

Record deactivated on June 25, 2026

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 59 N MAIN ST, EARLVILLE, NY 13332 (Tel: 3156916502)

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Updated Business Mailing Address July 08, 2007

Registered at PO BOX 360, 59 N MAIN ST, EARLVILLE, NY 13332 (Tel: 3156916502)

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Provider Name / Credentials Updated July 08, 2007

Recorded as ROBERT JACKSON, DDS

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

Dentist (License #038574 in NY)

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Initial NPI Registration & Enumeration April 13, 2007

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: 1598989030
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 13, 2007
Last Update: July 08, 2007
Deactivation Date: June 25, 2026

Mailing Address

Po Box 360, 59 N Main St

Earlville, NY 13332

Phone: 3156916502

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.