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

Stacy Marie Jackson, DDS

Individual provider Dentist · NPI 1043530991

Stacy Marie Jackson, DDS is a Dentist in Boulder, Colorado. Practices as a sole proprietor and works from 2 locations. Licensed in Colorado and Missouri.

Licensed in
CO, MO
In the registry since
2010
Specialties on file
2
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

3400 Penrose Pl Ste 107
Boulder, CO 80301-1809
Phone: (303) 443-8250
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 5150 W 80th Ave, Westminster, CO 80030-4449 — (303) 427-1951

Specialties & licences

Pediatric Dentistry (primary) Taxonomy 1223P0221X · Licence DEN.00202791 (CO)
Dentist Taxonomy 122300000X · Licence 2010016174 (MO)

Record details

NPI number1043530991
Entity typeIndividual (Type 1)
GenderFemale
Credentials DDS
Sole proprietorYes
NPI enumeratedJune 2, 2010
Last updated in NPPESApril 26, 2023
Certification dateApril 26, 2023
Mailing address291 Maddox Lane, Erie, CO 80516

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