IndividualActive
Marylyn Jackson
NPI 1023359510 · General Practice Dentistry · Olympia Fields, IL
Provider details
- NPI number
- 1023359510
- Entity type
- Individual
- Primary specialty
- General Practice DentistryDental Providers
- Sex
- Female
- Sole proprietor
- No
- License
- 019-017207 (IL)
Specialties & taxonomies
Dental Providers
Dental Providers
Profile Score
Detailed profile(78/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
13 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
2555 Lincoln Hwy
Suite 113
Olympia Fields, IL 60461-1936
Phone: (708) 679-0668
Street-level locationGet directions
Mailing address
2555 Lincoln Hwy
Olympia Fields, IL 60461-1936
Registry dates
- Enumerated
- 2013-03-07
- Last updated
- 2013-03-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.