Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JEFFREY JACKY, DENTURIST LD
Active Sole Proprietor122400000X · BEAVERTON, OR
Registration Details
- NPI Number
- 1356791677
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jun 17, 2016 (9.8675464710754 yrs)
- Last Updated
- Jun 26, 2023
- License
-
DTDO709602 (OR)
- Sole Proprietor
- Yes
Practice Information
- Address
-
4925 SW GRIFFITH DRBEAVERTON, OR, 970052923Browse OR providers · Browse ZIP 97005
- Phone
- 8554336825
- Primary Specialty
-
122400000X
122400000X
Other 122400000X Providers in BEAVERTON, OR
| Name | Credential | NPI |
|---|---|---|
| MICHAEL MOGA | LD | 1730226333 |
| MRS. ESTHER C OH | — | 1730391087 |
| KRISTINE S. BAHNG | LD | 1992918361 |
| MIN-U TAN | — | 1629777552 |
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.