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

Dr. Larry Tyler Jackson, DDS

Individual provider Pediatric Dentistry · NPI 1396186276

Dr. Larry Tyler Jackson, DDS is a 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
Mailing address14100 N 83rd Ave, Ste 280, Peoria, AZ 85381-5658

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