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

Scott Jacks DDS Inc

Organization Dentist · NPI 1366549545

Scott Jacks DDS Inc is a Dentist in South Gate, California. Licensed in Arizona and California. Registered with an NPI since 2006.

Licensed in
AZ, CA
In the registry since
2006
Specialties on file
6
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4444 Tweedy Blvd
South Gate, CA 90280-6304
Phone: (323) 564-2444
Fax: (564) 249-7565
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 31668 (AZ)
Endodontics Taxonomy 1223E0200X · Licence 31668 (CA)
Pediatric Dentistry Taxonomy 1223P0221X · Licence 31668 (CA)
Periodontics Taxonomy 1223P0300X · Licence 31668 (CA)
Oral and Maxillofacial Surgery (Dentist) Taxonomy 1223S0112X · Licence 31668 (CA)
Orthodontics and Dentofacial Orthopedics Dentistry Taxonomy 1223X0400X · Licence 31668 (CA)

Record details

NPI number1366549545
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jerry Minsky — Owner · (323) 564-2444
Other names Children'S Dental Group
NPI enumeratedSeptember 20, 2006
Last updated in NPPESSeptember 23, 2015
Mailing address4444 Tweedy Blvd, South Gate, CA 90280-6304

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