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

Individual provider Oral and Maxillofacial Surgery (Dentist) · NPI 1124116066

Dr. Richard Fredrick Jackson, DDS is an Oral and Maxillofacial Surgery (Dentist) in Roseville, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2006
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

1441 Secret Ravine Pkwy Ste 160
Roseville, CA 95661-6044
Phone: (916) 787-1515
Fax: (916) 787-1516
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Oral and Maxillofacial Surgery (Dentist) (primary) Taxonomy 1223S0112X · Licence 24465 (CA)

Record details

NPI number1124116066
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS
Sole proprietorYes
NPI enumeratedOctober 10, 2006
Last updated in NPPESJune 5, 2015
Mailing address1441 Secret Ravine Pkwy, Suite 160, Roseville, CA 95661-6044

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