Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1669115770 Individual Practitioner Male Practitioner

Scott Christian Jackson

Dentist - General Practice • Memphis, TN

Professional Overview & Biography Verified Profile Summary

Scott Jackson is a registered healthcare professional specializing in Dentist - General Practice in Memphis, TN. Practice services are available at 5180 PARK AVE STE 210 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

5180 Park Ave Ste 210

Memphis, TN 381193530

Telephone 9017630850
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Memphis, TN

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 20.0 Yrs
State Avg: 13.5 Yrs
Regional Practice Density
236 Specialists

Practicing in Memphis, TN (2175 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: 2024-02-06
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License TN 12245

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.

Student in an Organized Health Care Education/Training Program

NUCC Taxonomy Code: 390200000X

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Secondary Practice Locations

875 Union Ave Ste C211

Memphis, TN 381033513

Phone: 9014486930

2059 S Houston Levee Rd Ste 126

Germantown, TN 381396970

Phone: 9014250444

Practice Associates & Co-Workers

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

1 Associated Practitioners
Lauren Henderson

Dentist - General Practice

NPI 1992200364

Career & Practice History Timeline

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

8 Historical Events
📍
Updated Practice Location February 06, 2024

Registered at 5180 PARK AVE STE 210, MEMPHIS, TN 381193530 (Tel: 9017630850)

📍
Updated Practice Location June 28, 2023

Registered at 2059 S HOUSTON LEVEE RD STE 126, GERMANTOWN, TN 381396970 (Tel: 9014250444)

NPI Profile Active April 16, 2022

NPI status registered as active in NPPES database

📍
Updated Practice Location April 16, 2022

Registered at 875 UNION AVE STE C211, MEMPHIS, TN 381033513 (Tel: 9014486930)

📍
Updated Business Mailing Address April 16, 2022

Registered at 17649 ROCKWOOD ARBOR DR, EUREKA, MO 630254035 (Tel: 6362363714)

👤
Provider Name / Credentials Updated April 16, 2022

Recorded as SCOTT JACKSON

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 16, 2022

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration April 16, 2022

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: 1669115770
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 16, 2022
Last Update: February 06, 2024
Sole Proprietor: No

Mailing Address

17649 Rockwood Arbor Dr

Eureka, MO 630254035

Phone: 6362363714

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.