Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1912981945 Individual Practitioner Male Practitioner

Dr. Theodore Michael Jackson , DMD

Dentist • Columbus, OH

Professional Overview & Biography Verified Profile Summary

Dr. Theodore Jackson, DMD is a registered healthcare professional specializing in Dentist in Columbus, OH. Practice services are available at 305 W 12TH AVE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

305 W 12th Ave

Columbus, OH 432101267

Telephone 6142476590
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Columbus, OH

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 9.0 Yrs
State Avg: 18.4 Yrs
Regional Practice Density
317 Specialists

Practicing in Columbus, OH (2953 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

CMS Verified: 2023-02-21
Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

State License OH 30.026788

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.

Dentist - General Practice

NUCC Taxonomy Code: 1223G0001X

State License IL 19026503

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

40 Associated Practitioners
NPI 1013151943

Doctor of Dental Surgery

Mitchell Thai

Dentist - General Practice

NPI 1013750413
Dr. Diana Mahmoodi , DMD

Dentist - Prosthodontics

NPI 1013807403

Doctor of Dental Medicine

NPI 1023165651

Doctor of Dental Surgery

NPI 1023373701

Doctor of Dental Surgery

Dr. Jennifer Burzynski , DMD

Dentist - Orthodontics and Dentofacial Orthopedics

NPI 1023409349

Doctor of Dental Medicine

Career & Practice History Timeline

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

13 Historical Events
📍
Updated Practice Location February 21, 2023

Registered at 305 W 12TH AVE, COLUMBUS, OH 432101267 (Tel: 6142476590)

📍
Updated Business Mailing Address February 21, 2023

Registered at 1254 N HIGH ST APT 307, COLUMBUS, OH 432012438 (Tel: 6186165324)

NPI Profile Active April 09, 2018

NPI status registered as active in NPPES database

📍
Updated Practice Location April 09, 2018

Registered at 331 SIJEN AVE, WHITEMAN AFB, MO 653051269 (Tel: 6606872201)

📍
Updated Business Mailing Address April 09, 2018

Registered at 1832 VETERANS RD, WARRENSBURG, MO 640938212 (Tel: 6186165324)

👤
Provider Name / Credentials Updated April 09, 2018

Recorded as THEODORE JACKSON, D.M.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 09, 2018

Dentist (License #19026503 in IL)

NPI Profile Active November 28, 2012

NPI status registered as active in NPPES database

📍
Updated Practice Location November 28, 2012

Registered at PSC 9 BOX 1605, APO, AE 091230017 (Tel: 4915140527167)

📍
Updated Business Mailing Address November 28, 2012

Registered at PSC 9 BOX 1605, APO, AE 091230017

👤
Provider Name / Credentials Updated November 28, 2012

Recorded as THEODORE JACKSON, D.M.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) November 28, 2012

Dentist (License #19026503 in IL)

🟢
Initial NPI Registration & Enumeration December 02, 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: 1912981945
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: December 02, 2005
Last Update: February 21, 2023
Sole Proprietor: No

Mailing Address

1254 N High St Apt 307

Columbus, OH 432012438

Phone: 6186165324

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.