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Deactivated NPI 1073700142 Deactivated / Inactive NPI Male Practitioner

Dr. Thomas R. Jackson , DDS, PA

Dentist • Mount Airy, NC

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

Registration / Start Date October 02, 2007
NPI Deactivation Date March 16, 2022
Total Practice Duration ~15 Years of Practice (2007 – 2022)

Professional Overview & Biography Verified Profile Summary

Dr. Thomas Jackson, DDS, PA was a registered Dentist practicing in Mount Airy, NC. Throughout an active medical career spanning 15 years, Dr. Jackson provided care at the practice location at 1007 ROCKFORD ST until profile deactivation on 2022-03-16.

Practice Location & Contact Primary Location

Practice Address

1007 Rockford St

Mount Airy, NC 270305325

Telephone 3367891025
Fax 3367891158
Associated Practice Facility / Clinic
🏢 Dr Larry Dean Simmons Dds Pa Facility NPI 1033221098

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Mount Airy, NC

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 13.2 Yrs
Regional Practice Density
10 Specialists

Practicing in Mount Airy, NC (2435 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 NC 4074

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.

Practice Associates & Co-Workers

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

2 Associated Practitioners
Dr. Yoonho Sung , DDS

Dentist - General Practice

NPI 1396687836

Doctor of Dental Surgery

Dr. Jason Barrett , DDS

Dentist - General Practice

NPI 1649607946

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 16, 2022

Record deactivated on March 16, 2022

NPI Profile Active October 02, 2007

NPI status registered as active in NPPES database

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Updated Practice Location October 02, 2007

Registered at 1007 ROCKFORD ST, MOUNT AIRY, NC 270305325 (Tel: 3367891025)

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Updated Business Mailing Address October 02, 2007

Registered at 1007 ROCKFORD ST, MOUNT AIRY, NC 270305325 (Tel: 3367891025)

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Provider Name / Credentials Updated October 02, 2007

Recorded as THOMAS JACKSON, DDS, PA

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Medical Taxonomy / Specialty Registered (Primary Specialty) October 02, 2007

Dentist (License #4074 in NC)

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Initial NPI Registration & Enumeration October 02, 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: 1073700142
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 02, 2007
Last Update: October 02, 2007
Deactivation Date: March 16, 2022

Mailing Address

1007 Rockford St

Mount Airy, NC 270305325

Phone: 3367891025

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.