IndividualActive
Ernest Jackson, DDS
NPI 1124113246 · Public Health Dentistry · Clayton, MO
Provider details
- NPI number
- 1124113246
- Entity type
- Individual
- Primary specialty
- Public Health DentistryDental Providers
- Credential
- DDS
- Sex
- Male
- Sole proprietor
- No
- License
- 014969 (MO)
Practice location
111 S Meramec Ave
Clayton, MO 63105-1711
Phone: (314) 615-8153
Fax: (314) 615-8303
Mailing address
3702 W Truman Blvd Ste 100
Jefferson City, MO 65109-4970
Registry dates
- Enumerated
- 2006-10-04
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.