Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Philip Rodney Jackson, DMD

Individual provider Dentist · NPI 1790963916

Dr. Philip Rodney Jackson, DMD is a Dentist in Columbia, South Carolina. Licensed in South Carolina. Registered with an NPI since 2008.

Licensed in
SC
In the registry since
2008
Specialties on file
2
What do these letters mean?
DMD — Doctor of Dental Medicine
A dentist. Identical training and licensing to a DDS.

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Practice location Address checks out

857 Shore View Dr
Columbia, SC 29212-8365
Phone: (803) 609-5216
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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 2416 (SC)
Dentist Taxonomy 122300000X · Licence 2416 (SC)

Record details

NPI number1790963916
Entity typeIndividual (Type 1)
GenderMale
Credentials DMD
Sole proprietorNo
NPI enumeratedFebruary 11, 2008
Last updated in NPPESSeptember 30, 2022
Certification dateSeptember 23, 2022

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