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Stephanie Jackson, RDH — NPI 1205045796, Provo, UT | NPI Central

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NPI 1205045796

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Stephanie Jackson, RDH

NPI 1205045796 · Dental Hygienist · Provo, UT

Provider details

NPI number: 1205045796
Entity type: Individual
Primary specialty: Dental HygienistDental Providers
Credential: RDH
Sex: Female
Sole proprietor: No
License: 13208 (TX)

Specialties & taxonomies

Dental HygienistPrimary124Q00000XLicense 5655443-0701 (UT)
Dental Providers
Dental Hygienist124Q00000XLicense 13208 (TX)
Dental Providers
Dental Hygienist124Q00000XLicense 5908 (AZ)
Dental Providers

Practice location

801 Crestview Ave

Provo, UT 84604-4777

Phone: (801) 222-9354

Approximate (ZIP-level) locationGet directions

More UT providers

Mailing address

801 Crestview Ave

Provo, UT 84604-4777

Registry dates

Enumerated: 2007-05-21
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.