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

Pediatric Dentistry and Orthodontics of Jackson

Organization Pediatric Dentistry · NPI 1952058133

Pediatric Dentistry and Orthodontics of Jackson is a Pediatric Dentistry in Jackson, Michigan. Registered with an NPI since 2022.

In the registry since
2022
Specialties on file
2

Practice location Address checks out

900 E Michigan Ave Ste 100
Jackson, MI 49201-2457
Phone: (517) 376-3142
Show map & directions

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

Specialties & licences

Pediatric Dentistry (primary) Taxonomy 1223P0221X
Orthodontics and Dentofacial Orthopedics Dentistry Taxonomy 1223X0400X

Record details

NPI number1952058133
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Ly Van — Pediatric Dentist · (586) 744-9869
NPI enumeratedMarch 7, 2022
Last updated in NPPESMarch 7, 2022
Certification dateMarch 7, 2022
Mailing address900 E Michigan Ave Ste 100, Jackson, MI 49201-2457

Other providers in Jackson