Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jackson Creek Dental

Organization General Practice Dentistry · NPI 1295062339

Jackson Creek Dental is a General Practice Dentistry in Bloomington, Indiana. Licensed in Indiana. Registered with an NPI since 2009.

Licensed in
IN
In the registry since
2009
Specialties on file
2

Practice location Address checks out

1124 S College Mall Rd
Bloomington, IN 47401
Phone: (812) 336-5525
Fax: (812) 332-5520
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence 12010765 (IN)
General Practice Dentistry Taxonomy 1223G0001X · Licence 12010729 (IN)

Record details

NPI number1295062339
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Ryan Tschettei — Owner · (812) 336-5525
NPI enumeratedNovember 11, 2009
Last updated in NPPESMay 17, 2018
Mailing address1124 S College Mall Rd, Bloomington, IN 47401

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