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

Dr. Jacy Craig Nelson, DDS

Individual provider General Practice Dentistry · NPI 1225015977

Dr. Jacy Craig Nelson, DDS is a General Practice Dentistry in Renton, Washington. Practices as a sole proprietor. Licensed in Washington.

Licensed in
WA
In the registry since
2005
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.

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Practice location Address checks out

14300 SE Petrovitsky Rd
Renton, WA 98058-8955
Phone: (253) 852-0206
Fax: (253) 852-6351
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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 DE00009342 (WA)

Record details

NPI number1225015977
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS
Sole proprietorYes
NPI enumeratedDecember 23, 2005
Last updated in NPPESMarch 18, 2026
Certification dateMarch 18, 2026
Mailing address14300 Se Petrovitsky Rd, Renton, WA 98058-8955

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