Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Dr. Larry Tyler Jackson, DDS

Individual provider Pediatric Dentistry · NPI 1396186276

Dr. Larry Tyler Jackson, DDS practises Pediatric Dentistry in Peoria, Arizona. Licensed in Arizona. Registered with an NPI since 2013.

Licensed in
AZ
In the registry since
2013
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

14100 N 83rd Ave Ste 280
Peoria, AZ 85381-5658
Phone: (623) 935-9873
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Dentistry (primary) Taxonomy 1223P0221X · Licence D009113 (AZ)

Record details

NPI number1396186276
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS
Sole proprietorNo
NPI enumeratedJuly 8, 2013
Last updated in NPPESApril 7, 2017

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