Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
STACY MARIE JACKSON, DDS
Active Sole ProprietorSTACY MARIE JACKSON, DDS is a Pediatric Dentistry healthcare provider located in BOULDER, Colorado. NPI 1043530991 is currently active in the NPPES registry. Verify at CMS.
Pediatric Dentistry · BOULDER, CO
Registration Details
- NPI Number
- 1043530991
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jun 2, 2010 (16.231197767777 yrs)
- Last Updated
- Apr 26, 2023
- Licenses
-
2010016174 (MO)DEN.00202791 (CO)
- Sole Proprietor
- Yes
Practice Information
- Address
-
3400 PENROSE PL STE 107BOULDER, CO, 803011809Browse CO providers · Browse ZIP 80301
- Phone
- 3034438250
- Primary Specialty
-
Pediatric Dentistry
1223P0221X
- Additional Specialty
- Pediatric Dentistry
Other Pediatric Dentistry Providers in BOULDER, CO
| Name | Credential | NPI |
|---|---|---|
| DR. MICHAEL D JONES | D.D.S. | 1043286107 |
| DR. ROBERT S PANKRATZ | DDS | 1801816046 |
| DR. IAN MICHAEL KOTT | DDS | 1215009220 |
| JENNIFER DANIELA FRIEDMAN | DMD | 1629319892 |
| SAMANTHA MARIE GRAFFEO GARDNER | DDS | 1952954620 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.