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

Dr. Jesse L Jackson, DDS

Individual provider Customized Equipment (DME) · NPI 1235458514

Dr. Jesse L Jackson, DDS is a Customized Equipment (DME) in Kansas City, Missouri. Licensed in Missouri. Registered with an NPI since 2010.

Licensed in
MO
In the registry since
2010
Specialties on file
2
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

8650 NE Shoal Creek Valley Dr
Kansas City, MO 64157-8063
Phone: (816) 429-5799
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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 2010016173 (MO)
Customized Equipment (DME) Taxonomy 332BC3200X · Licence 2010016173 (MO)

Record details

NPI number1235458514
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS
Sole proprietorNo
NPI enumeratedMay 25, 2010
Last updated in NPPESNovember 10, 2025
Certification dateNovember 10, 2025
Mailing address8650 Ne Shoal Creek Valley Dr, Kansas City, MO 64157-8063

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