Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1083442164 Individual Practitioner Male Practitioner

Dr. Jackson Van , DMD

Dentist - General Practice • Gladstone, OR

Professional Overview & Biography Verified Profile Summary

Dr. Jackson Van, DMD is a registered healthcare professional specializing in Dentist - General Practice in Gladstone, OR. Practice services are available at 20140 MCLOUGHLIN BLVD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

20140 Mcloughlin Blvd

Gladstone, OR 970272604

Telephone 9714041374
Associated Practice Facility / Clinic
🏢 Gladstone Smiles Dentistry Pc Facility NPI 1376036764

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Gladstone, OR

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 13.7 Yrs
Regional Practice Density
6 Specialists

Practicing in Gladstone, OR (1994 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: 2024-11-18
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License OR D12050

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.

Career & Practice History Timeline

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

6 Historical Events
NPI Profile Active July 22, 2024

NPI status registered as active in NPPES database

📍
Updated Practice Location July 22, 2024

Registered at 20140 MCLOUGHLIN BLVD, GLADSTONE, OR 970272604 (Tel: 9714041374)

📍
Updated Business Mailing Address July 22, 2024

Registered at 10952 SE LENORE ST, HAPPY VALLEY, OR 970868789 (Tel: 5034759235)

👤
Provider Name / Credentials Updated July 22, 2024

Recorded as JACKSON VAN, DMD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 22, 2024

Dentist (License #D12050 in OR)

🟢
Initial NPI Registration & Enumeration July 22, 2024

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: 1083442164
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 22, 2024
Last Update: November 18, 2024
Sole Proprietor: Yes

Mailing Address

10952 Se Lenore St

Happy Valley, OR 970868789

Phone: 5034759235

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.