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

Individual provider Dentist · NPI 1619538436

Ryne Jackson, DMD, MSD is a Dentist in Surprise, Arizona. Practices as a sole proprietor. Licensed in Arizona and Louisiana.

Licensed in
AZ, LA
In the registry since
2019
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

15294 W Brookside Ln Ste 100
Surprise, AZ 85374-2446
Phone: (623) 376-7400
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Endodontics (primary) Taxonomy 1223E0200X · Licence D012024 (AZ)
Dentist Taxonomy 122300000X · Licence 7005 (LA)

Record details

NPI number1619538436
Entity typeIndividual (Type 1)
GenderMale
Credentials DMD , MSD
Sole proprietorYes
NPI enumeratedJune 24, 2019
Last updated in NPPESJuly 14, 2025
Certification dateJuly 14, 2025
Mailing address24125 N 160th Ave, Surprise, AZ 85387-1629

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