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

Jackson Family Dentistry LLC

Organization General Practice Dentistry · NPI 1114317815

Jackson Family Dentistry LLC is a General Practice Dentistry in Jackson, Wisconsin. Licensed in Wisconsin. Registered with an NPI since 2015.

Licensed in
WI
In the registry since
2015
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

N168W20060 Main St
Jackson, WI 53037-9382
Phone: (262) 677-3003
Fax: (262) 677-1641
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence 3671-15 (WI)

Record details

NPI number1114317815
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Scott Charmoli — Owner · (262) 677-3003
NPI enumeratedFebruary 2, 2015
Last updated in NPPESFebruary 2, 2015
Mailing addressN168w20060 Main St, Jackson, WI 53037-9382

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